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Mental health billing service (MHBS) is a billing partner for psychiatrists, psychologists, LCSWs, and group behavioral health practices. We code time-banded psychotherapy sessions against start and stop times, route claims through the correct MBHO carve-out for each member’s plan, and keep telehealth modifiers and POS rules current across all 50 states.
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Behavioral health billing means coding the session, submitting the claim, and collecting what the plan owes for mental health and substance use care. The rails match any specialty. We send 837P claims, post 835 remittances, verify coverage on 270/271, and watch the clean-claim rate to see how the operation runs. The rules wrapped around those rails are what set behavioral health apart: where the claim has to go, how far a plan can limit it, what the records demand, and which code each clinician’s license allows.
Those rules touch nearly every claim. Practices can deliver flawless care and still collect far less than it earned. Document the session perfectly, code it correctly, route it to the wrong payer, and it denies anyway. MHBS (Mental Health Billing Services) minimize this uncertainty between the clinical work and the deposit.
MHBS manages the complete behavioral health revenue cycle, from the eligibility check before the first session to the AR follow-up that closes the last open balance. Twelve service lines make up the work. Each one runs with behavioral-health-specific rules underneath it, not a general medical template with the specialty name swapped in.
Before the first date of service, we run a 270/271 eligibility inquiry and read the response the way behavioral health demands: which carve-out owns the benefit, whether session limits apply, where the deductible and accumulator stand, and what parity says those limits are allowed to be. Your patient gets an honest picture of their coverage before care begins, and the claim that follows already has its destination right.
We obtain and track authorizations for testing, ABA, TMS, and level-of-care services, where almost nothing pays without one. That includes concurrent review for IOP, PHP, and residential stays, retro authorization when an emergency made advance approval impossible, and single case agreements or gap exceptions when the patient’s plan has no in-network option. Authorization numbers go on the claim, and expiration dates go on a calendar someone watches.
Our AAPC and AHIMA certified coders work in ICD-10 F-codes aligned to DSM-5-TR, the psychotherapy CPT set with its time bands, HCPCS for SUD and facility services, and the add-ons that change reimbursement, like 90785 for interactive complexity. Coding happens against the documentation, so a 60-minute session bills as 90837 with the minutes in the note.
Charges get captured from the encounter, entered against the right fee schedule, and scrubbed before submission. The scrub checks the behavioral health failure points: taxonomy against the rendering license, POS against the telehealth modifier, authorization number present where one is required, time band matching the documented minutes. A claim that would fail a payer edit fails ours first, while it can still be fixed in minutes instead of weeks.
Claims transmit as 837P files for professional services and 837I for facility claims, through Availity, Change Healthcare, Waystar, or Office Ally, whichever your setup uses. We read the 999 and 277CA acknowledgments the same day, because a rejection caught at the clearinghouse costs minutes and the same rejection discovered a month later costs the filing window. Routing logic sends each claim to the carve-out, not the medical payer.
835 ERAs post daily, with contractual adjustments verified against the fee schedule rather than accepted on faith. We reconcile what the payer paid against what the contract says, flag underpayments, and manage COB so primary and secondary payers process in the right order. Revenue leakage hides in posting, a few dollars per claim across thousands of claims, and it can be found in reconciliation.
General billers assume the insurer on the card pays the claim. Behavioral health breaks that assumption constantly, and it breaks in four places. We built the workflow around all four, because a biller who has never looked for them finds out when the denials land.
The benefit belongs to someone else
Commercial plans hand the behavioral benefit to a separate company that runs its own network, fees, and authorizations. UnitedHealthcare uses Optum, Anthem uses Carelon, Cigna uses Evernorth. The routing changes by plan and state, so we confirm it rather than guess.
Send the claim to the medical payer and it denies immediately, and the rerouting eats days off the filing window. We verify the carve-out during eligibility and land the first submission at the right payer.
Plans can only limit so far
Federal parity law (MHPAEA) stops a plan from restricting behavioral health more tightly than comparable medical care, down to quiet limits like repeat prior authorization. Some restrictions behind a denial will not hold up against a parity comparison.
We read restrictive denials with parity in mind and challenge the ones that warrant it. That takes judgment, not a blanket promise to recover revenue, and we treat it that way.
Substance use records and HIPPA
SUD treatment records carry consent and redisclosure rules stricter than HIPAA, and a standard HIPAA authorization will not clear them. Claims, statements, and benefit checks can each expose a diagnosis when the workflow ignores Part 2.
We bill substance use through a Part 2 workflow from intake on, so a statement never discloses to the wrong household and the rule lives in the process instead of a footnote.
Clinicians bill and taxonomy
Each license carries its own NPI taxonomy code and its own rate, and behavioral health draws on a set most billers rarely touch. Mismatch the enrolled taxonomy against the rendering clinician and the claims deny in ways that look random until someone reads the credentialing file.
We match taxonomy to license at enrollment and track the session caps plans apply. A claim never goes out carrying the wrong code or crossing a time limit.
We work inside TherapyNotes, SimplePractice, Valant, and Kareo/Tebra, and move claims through Availity, Change Healthcare, Waystar, and Office Ally. Your documentation workflow stays exactly as it is.
Other billing companies bill twenty specialties, and the software-led ones use the billing service mostly to sell the platform.
Carve-out routing
Parity (MHPAEA)
42 CFR Part 2
Taxonomy by license
Level of care / ASAM
CoCM / BHI
Geographic reach
Operating model
Every behavioral health service maps to a CPT or HCPCS code, and the code determines the documentation, the authorization requirement, and the payment. We bill all of them.
90791 reports the psychiatric diagnostic evaluation, and 90792 the version with medical services, the one psychiatrists and PMHNPs use when the intake includes an E/M component. These plans pay one per episode of care, so the date matters.
Individual therapy bills by documented time: 90832 for 16 to 37 minutes, 90834 for 38 to 52, 90837 for 53 and up. CBT, DBT, EMDR, IPT, psychoanalysis, biofeedback, hypnotherapy, and play therapy all bill through this same code set; the modality lives in the documentation while the code reports the time. Add 90785 when interactive complexity applies, and never bill it alone. Some plans review 90837 more closely than the shorter codes, which is one more reason the minutes belong in the note.
Psychiatrists and PMHNPs bill E/M codes 99202–99205 for new patients and 99212–99215 for established ones. When therapy happens in the same visit as medication management, the add-ons 90833, 90836, and 90838 capture it, and leaving them off is one of the most common ways psychiatric practices underbill their own work.
90839 reports the first 60 minutes of crisis psychotherapy and 90840 each additional 30. The documentation has to show the crisis state, the urgency, and the time, because payers read these closely.
90846 bills family therapy without the patient present, 90847 with the patient, and 90849 multi-family group. Group psychotherapy bills 90853 per session, per participant, which makes group programs a volume billing exercise where small errors multiply fast.
Testing splits into evaluation services (96130–96133) and administration and scoring (96136–96139). It is one of the most authorization-heavy corners of behavioral health, so we secure the prior authorization and confirm the unit counts before the first instrument is given, not after the claim is denied.
HBAI codes, 96156 for assessment and 96158–96161 and 96164–96171 for intervention, report behavioral work tied to a medical condition rather than a psychiatric diagnosis. They open the door to billing psychological care inside medical populations, and most generic billers have never submitted one.
Applied behavior analysis bills the 97151–97158 adaptive behavior set plus 0362T and 0373T, all unit-based, virtually all requiring prior authorization, and most requiring careful tracking of who rendered each unit. Our ABA billing page goes deeper on the model.
SUD billing runs on HCPCS: H0001 for assessment, H0004 and H0005 for counseling, H0015 for intensive outpatient, H0020 for methadone administration in MAT programs, and H0050 for brief intervention. Every one of these moves under 42 CFR Part 2, and several vary by state Medicaid program.
Transcranial magnetic stimulation bills 90867 for initial planning and delivery, 90868 for subsequent sessions, and 90869 for re-planning, with strict medical-necessity criteria attached. ECT bills 90870 per session. Both demand documentation of failed prior treatment, and both are services where one missing record can unwind an entire course of care financially.
Telehealth behavioral health turns on in place of service and modifiers: POS 10 when the patient is home, POS 02 when they're elsewhere, modifier 95 for audio-video, modifier 93 for audio-only where the payer permits it. The combinations payers accept vary, and they change. We track them so your telehealth claims don't become an experiment.
MHBS bills behavioral health in all 50 states, and the state layer is where billing knowledge gets tested. Medicaid behavioral health runs through different MCOs, carve-outs, and modifier schemes in every state, parity enforcement varies, and even license titles change at the border. The eighteen states below carry the most behavioral health volume in the country, and each one has a wrinkle worth knowing before the first claim goes out.
MHBS prices behavioral health billing as a percentage of collections, with flat-fee options for facilities that prefer a predictable number. Every engagement starts with a free billing audit and you see what’s recoverable before you commit to anything.
The Mental health billing service (MHBS) 90-day audit reviews recent claim history. Revenue issues get sorted by category. A written report shows exactly where performance can improve, inside 48 hours.
Behavioral health billing is the work of coding, submitting, and collecting payment for mental health and substance use services. It runs from eligibility checks and prior authorization through claim submission on the 837P, payment posting from the 835 ERA, denial management, and AR follow-up, under rules like MHPAEA parity and 42 CFR Part 2 that general medical billing rarely touches.
Behavioral health adds layers of general medical billing skips. Most commercial plans carve behavioral health out to an MBHO such as Optum, Carelon, Evernorth, or Magellan, so claims must route to the carve-out, not the medical payer. Plans apply session limits and MHPAEA parity rules, SUD records sit under 42 CFR Part 2, and master's-level clinicians bill under license-specific taxonomy codes. Miss any of these and the denials follow.
A carve-out is a managed behavioral health organization a health plan hires to run its mental health and substance use benefits. Optum manages behavioral health for UnitedHealthcare, Carelon for Anthem, Evernorth for Cigna, and Lucet for Blue KC and BCBS Kansas. The carve-out holds its own network, fee schedules, and authorization rules, separate from the medical plan.
Because the medical payer on the card doesn't administer the behavioral benefit. UnitedHealthcare delegates it to Optum, Anthem to Carelon, Cigna to Evernorth. A psychotherapy claim sent to the medical plan is denied on arrival, usually with a remark pointing to the carve-out, and the timely filing clock keeps running while it gets rerouted.
MHPAEA is the federal law that says behavioral health benefits can't be more restrictive than a plan's medical and surgical benefits. That applies to visit caps and copays, and to quieter limits like prior authorization frequency. For billing, parity violations are recoverable revenue: a session limit or authorization demand that fails parity can be challenged and the claims paid.
42 CFR Part 2 protects substance use disorder treatment records with consent requirements stricter than HIPAA, including limits on redisclosure. In billing, that touches claims, patient statements, and coordination-of-benefits inquiries, any of which can expose treatment information. SUD billing has to run through a Part 2 workflow with specific written consent, not a generic HIPAA process.
The codes most practices live on: 90791 and 90792 for diagnostic evaluation, 90832, 90834, and 90837 for individual psychotherapy by time, 90846 and 90847 for family therapy, 90853 for group, and 99212 through 99215 for psychiatric medication management, often with the add-ons 90833, 90836, or 90838 when therapy happens in the same visit.
By documented time. 90832 is 16 to 37 minutes of psychotherapy, 90834 is 38 to 52, and 90837 is 53 or more. The minutes belong in the note, because several plans review 90837 more closely than the shorter codes. Add 90785 when interactive complexity applies, and never bill 90785 on its own.
CoCM is billed monthly, by time, from the primary care side. 99492 reports the first 70 minutes in the initial month, 99493 the first 60 minutes in later months, 99494 each additional 30 minutes, and G2214 a 30-minute month. The model pairs a behavioral health care manager with a consulting psychiatrist under the treating provider's claim.
Place of service tells the story: POS 10 when the patient is at home, POS 02 when they're elsewhere. Modifier 95 marks audio-video sessions and modifier 93 marks audio-only, where the payer permits it. Payers differ on which combinations they accept, so the POS and modifier rules get checked per plan, not assumed.
Yes. Medicare opened enrollment to marriage and family therapists and mental health counselors in January 2024, and that includes LPC and LMHC license titles depending on the state. They enroll under their own taxonomy codes, 106H00000X for LMFTs and 101YM0800X for counselors, and bill the psychotherapy code set directly.
Intensive outpatient bills under S9480 or H0015 with revenue codes 0905 and 0906, and partial hospitalization under H0035 with revenue codes 0912 and 0913. Both are level-of-care services, which means authorization up front and concurrent review while the patient remains in treatment. Miss a review window and the days stop being payable.
MHBS charges a percentage of collections, with flat-fee options for facilities that prefer a predictable number. There are no setup fees and no long-term contracts. Every engagement starts with a free billing audit, so you see what's recoverable before committing to anything.
A healthy behavioral health operation runs a 95%+ clean-claim rate, meaning at least 95 of every 100 claims pass payer edits on first submission. Getting there takes correct carve-out routing, license-matched taxonomy codes, time-band coding on psychotherapy, and scrubbing before submission. Below 90%, the practice is funding rework out of its own margin.
Yes. We work inside TherapyNotes, SimplePractice, Valant, and Kareo/Tebra, and we move claims through Availity, Change Healthcare, Waystar, and Office Ally. Nothing migrates, and your clinicians keep the documentation workflow they already have.
Yes. We bill in all 50 states and handle what multi-state telehealth raises: the clinician must be licensed where the patient sits, the place-of-service and modifier rules vary by payer, and Medicaid behavioral health runs through different MCOs and carve-outs in each state. Credentialing follows the same state-by-state logic.
Our free audit identifies it in under 48 hours: we review your denials, your payer mix, your carve-out routing, and your AR, then tell you exactly where the revenue is leaking and what it would take to recover it.
Simplifying mental health billing with accurate claims, faster reimbursements, and seamless revenue cycle management.
