Behavioral health medical billing covers psychiatry, individual and group therapy, and substance use treatment — a specialty built almost entirely on time-based coding, where the exact session length documented determines which code is billable, and where payer visit limits and authorization renewals create constant administrative overhead. TBC Solutions provides dedicated behavioral health billing so practices spend less time on paperwork and more time with patients.
Why Behavioral Health Billing Is Different
- Individual therapy billing is time-based — 90832 (30 minutes), 90834 (45 minutes), and 90837 (60 minutes) — and the code billed must match documented session length exactly, which is one of the most frequently audited details in behavioral health billing.
- Many payers cap the number of covered visits per year and require ongoing authorization renewals; missing a renewal deadline is one of the most common causes of behavioral health claim denials.
- Telehealth billing rules (place-of-service codes and modifiers like -95) shift periodically and vary by payer, and getting them wrong is an easy way to have an entire telehealth claim denied.
- The Mental Health Parity and Addiction Equity Act affects how payers are legally required to reimburse behavioral health versus medical claims, and disputes over parity compliance are common — a billing partner that understands this can resolve denials a generalist would not catch.
Our Behavioral Health Medical Billing Services
Charge Entry & Coding
Accurate CPT/ICD-10 coding by coders trained specifically in this specialty’s code sets and payer edits.
Claims Submission & Scrubbing
Every claim is scrubbed against payer-specific edits before submission to catch errors before they become denials.
Denial Management & Appeals
Denied claims are tracked, corrected, and appealed — not just resubmitted blind.
Payment Posting & Reconciliation
Payments are posted and reconciled against contracted rates to catch underpayments, not just track deposits.
Credentialing & Payer Enrollment
We handle payer enrollment and re-credentialing so billing isn’t interrupted by lapsed enrollment.
Patient Statements & Support
Clear, accurate patient statements and support fielding billing questions, reducing patient billing complaints.
Reporting & Analytics
Regular, transparent reporting on collections, denials, and days in accounts receivable — no black-box billing.
Common Behavioral Health Billing Challenges We Solve
Session length and code mismatch
Billing 90837 (60 minutes) when documentation supports only 45 minutes is one of the most common audit triggers in behavioral health; we cross-check documented time against the code billed before submission.
Authorization renewal lapses
Visit limits and authorization renewals are tracked proactively so care isn’t interrupted and claims aren’t denied for lapsed authorization.
Telehealth billing rule changes
Place-of-service codes and modifiers for telehealth visits are applied per current payer rules, which we monitor since they change more often than in-person billing rules.
Group therapy and add-on code billing
Group therapy (90853) and add-on codes like interactive complexity (90785) are frequently under-billed; we review session notes to ensure every billable service is captured.
Our Process
- Free Practice Audit: We review a sample of your recent claims, denial patterns, and current billing workflow at no cost and with no obligation.
- Onboarding & EHR/PM Integration: We integrate with your existing EHR/practice management system — no need to switch software.
- Coding & Claims Submission: Claims are coded and submitted using the specialty-specific rules covered in this document.
- Denial Management: Denied claims are corrected and appealed promptly, with root-cause tracking so the same denial doesn’t recur.
- Reporting & Optimization: Ongoing reporting identifies further revenue opportunities as your practice and payer mix evolve.
Why Practices Choose TBC Solutions for Behavioral Health Billing
- Coders trained on this specialty’s specific code sets, modifiers, and payer edits — not generalist billing applied to every specialty the same way.
- HIPAA-compliant handling of all patient and claims data, from intake through reporting.
- Transparent, regular reporting — you always know what was billed, what was paid, and what’s outstanding.
- A dedicated point of contact, not a rotating support queue.
Frequently Asked Questions
How do you make sure therapy session codes match documentation?
We cross-check the documented session length against the CPT code billed (90832, 90834, or 90837) before submission, since a mismatch is one of the most common audit triggers in behavioral health billing.
Do you track visit limits and authorization renewals?
Yes — we monitor payer-specific visit caps and authorization expiration dates proactively so care isn’t interrupted and claims aren’t denied for lapsed authorization.
Can you bill for telehealth behavioral health visits?
Yes. We apply current place-of-service codes and modifiers for telehealth, which we monitor closely since these rules change more frequently than in-person billing rules.
Do you bill for group therapy and add-on services?
Yes — including group therapy (90853) and add-on codes like interactive complexity, which are commonly under-billed when session notes aren’t fully reviewed.
Do you work with substance use treatment programs as well as therapy practices?
Yes — our behavioral health billing covers individual and group therapy practices, psychiatry, and substance use treatment programs.
How does TBC Solutions handle Mental Health Parity Act disputes?
We understand how parity law affects payer reimbursement obligations for behavioral health claims and factor this into how we appeal denials that don’t reflect parity requirements.
Get Started
Ready to stop losing revenue to preventable behavioral health billing denials? Book a Free Behavioral Health Billing Audit with TBC Solutions.