Mon–Fri, 8am–8pm EST · Speak to a real person, never a bot
Specialty billing

Behavioral Health Billing Services

Behavioral health billing depends on time-based codes, carve-out payers and telehealth rules that vary by plan. Nexra Connect handles psychotherapy, psychiatric and collaborative care claims so your clinicians can focus on patients.

The challenge

Why Behavioral Health billing is different.

Behavioral health carve-out payers and separate networks
Time-based psychotherapy documentation
Telehealth modifiers and place of service rules
Authorization and session limits
Our services

Behavioral Health billing expertise.

  • Psychiatric diagnostic evaluation billing
  • Psychotherapy coding by session time
  • Psychotherapy add-on codes with E/M services
  • Group and family therapy billing
  • Telehealth billing with correct modifiers and place of service
  • Collaborative care and integrated behavioral health codes
  • Session authorization tracking
  • Credentialing with carve-out networks
Coding expertise

Common Behavioral Health codes we work with.

CodeDescription
90791Psychiatric diagnostic evaluation
90834Psychotherapy, 45 minutes with patient
90837Psychotherapy, 60 minutes with patient
90833Psychotherapy, 30 minutes with patient when performed with an E/M service (add-on)
90853Group psychotherapy (other than of a multiple-family group)
99492Initial psychiatric collaborative care management, first 70 minutes in the first calendar month

CPT® is a registered trademark of the American Medical Association. Codes shown are examples; correct coding depends on documentation and payer policy.

Our process

Behavioral Health billing process.

1

Intake and Eligibility

  • Identifying carve-out behavioral health payers
  • Benefit verification for therapy and psychiatry
  • Authorization and session limit tracking
  • Telehealth coverage checks
2

Coding

  • Session time verification for psychotherapy codes
  • E/M plus psychotherapy add-on coding
  • Telehealth modifiers and place of service
  • Diagnosis coding to DSM and ICD-10 standards
3

Claim Submission

  • Routing claims to the correct carve-out payer
  • Scrubbing for frequency and authorization edits
  • Rendering provider credentialing checks
  • Timely electronic submission
4

Denial Management

  • Authorization and session limit appeals
  • Credentialing-related denial resolution
  • Telehealth denial corrections
  • Patient balance follow-up
5

Reporting

  • Sessions and revenue by clinician
  • Authorization utilization
  • Payer reimbursement comparisons
  • No-show impact on revenue
24 hrsClaim submission after documentation
CertifiedSpecialty-trained coders
DedicatedAccount manager for your practice
FAQ

Behavioral Health billing FAQs.

How is psychotherapy time coded?

Psychotherapy codes are selected by face-to-face time with the patient: 16 to 37 minutes for 90832, 38 to 52 minutes for 90834 and 53 minutes or more for 90837. Start and stop times or total time should be documented in every note.

What is a carve-out payer?

Some health plans contract behavioral health benefits to a separate company with its own network and claims address. We identify these carve-outs at intake so claims go to the right payer the first time.

How do you bill telehealth sessions?

Telehealth rules vary by payer, including which modifier and place of service code to use. We maintain payer-specific rules so virtual sessions are billed correctly.

Can psychiatrists bill therapy with medication management?

Yes. The E/M service is billed for medication management and a psychotherapy add-on code is billed when therapy time is separate and documented.

Ready to optimize your behavioral health revenue cycle?

Request a free consultation. We'll review your claims and show you where revenue is being lost.