Let’s talk about a huge frustration that mental health professionals like you deal with every day: billing.
You work tirelessly to help people. You fight battles with anxiety, depression, trauma, and so much more. But when it comes time to get paid? The system fights you back.
Ever had an insurance company send you a rejection like this:
“Service not medically necessary.”
Come on, they’re calling your life-changing work not necessary? You’ve seen the impact of your sessions. It’s infuriating.
Here’s the thing: Mental health billing isn’t just frustrating; it’s broken. Providers are underpaid, overworked, and constantly battling unpaid claims. But don’t worry, I’m here to help you simplify your mental health billing and avoid the common traps that keep you from getting paid.
💡 Tactical Tips to Take Back Control Over Your Mental Health Billing
🧠 1. Know the CPT Codes That Actually Pay
CPT codes—they’re the foundation of mental health billing. If you’re not using the right ones, you’re leaving money on the table. But don’t worry, you don’t need to memorize every code, just the ones that actually get you paid.
Here’s a quick cheat sheet for common mental health services:
-
90791 – Intake evaluation (no meds)
-
90834 – 45-minute therapy session
-
90837 – 60-minute therapy session
🗣️ Expert Quote #1
“The first step in mental health billing is learning the right codes. If you don’t, you’re literally leaving money on the table.”
— Barbara Griswold, LMFT, author of Navigating the Insurance Maze
💡 Pro Tip: Use billing software to track your mental health CPT codes and streamline the process. These systems can help avoid errors and simplify your claims.
📉 2. Don't Let Denials Take You Down
I’ll be honest, insurance claim denials are inevitable in behavioral health. The trick is to not let them stop you.
My first denied claim almost made me quit, but I learned the hard way: don’t just take “no” for an answer. Appeal. Push back. Get your documentation in order and fight for what you deserve.
🛑 3. Question “Best Practices”
You’ve heard it all before: “Sign up for every insurance panel under the sun.” But that’s a trap. Insurance companies often offer low reimbursement rates, and adding more panels means more work for you.
Instead of spreading yourself thin, focus on 2–3 high-paying insurance contracts and build your practice around those. Behavioral health billing doesn’t have to be a numbers game. It's about quality, not quantity.
🗣️ Expert Quote #2
“Don’t get caught up in the race to join every insurance panel. It’s about making the right contracts work for you.”
— Maureen Werrbach, LCPC, Group Practice Coach & Billing Expert
💬 4. Say It Like It Is—With Your Clients
Here’s the thing: billing for mental health services doesn’t need to be awkward.
When you’re out-of-network, just tell your clients. You don’t need to hide it or feel guilty. A simple script can save you tons of stress.
“I’m out-of-network, but I can give you a superbill so you can get reimbursed directly.”
Boom. That takes the pressure off you and helps your clients understand what to expect.
💥 5. Appeal Like a Boss
Don’t just accept an insurance rejection. You can appeal denials! Here’s a pro move: I once had a claim denied for “lack of documentation.” I fought it and resubmitted the paperwork. Guess what? The insurance company paid up.
Sometimes, mental health billing isn’t about the first no, but the persistence to get the right yes.
🤝 6. Find Your People and Outsource the Stress
You don’t need to be a billing expert to run a thriving mental health practice. Get help from a billing service or billing software. Don’t try to juggle everything yourself.
Having a team of billing professionals behind you will ensure that you’re not wasting time with coding mistakes or claim denials. Instead, focus on what you do best: helping your clients.
🗣️ Expert Quote #3
“You shouldn’t be doing your own billing if you’re not an expert. It’s too time-consuming and error-prone. Delegate!”
— Danielle Kepler, LCPC, founder of Be Your Own Biller
🧭 Mini Testimonial
“I started following these tips and now I’ve successfully appealed two denied claims. I also stopped accepting low-paying contracts, and my practice is finally thriving. These changes saved me hours each week!” — L, LCSW
📚 References
-
CMS Updates on Mental Health Telehealth Billing in 2025
Read about the latest telehealth policy updates from CMS
👉 Click here -
Study Reveals 37% Denial Rate for Mental Health Claims in 2024
Explore the KFF’s findings on mental health claim denials
👉 Click here -
AMA Issues CPT Code Revisions Affecting Behavioral Health Billing
Review the AMA’s latest behavioral health coding guide
👉 Click here
🤔 FAQ on Mental Health Billing
1. What are the most common issues with mental health billing?
The biggest problems include insurance denials, incorrect CPT codes, and coding errors. Many providers don’t realize they’re using outdated or inaccurate codes, which can lead to lost income.
2. How can I prevent insurance denials for mental health services?
To avoid denials, make sure you’re using the correct CPT codes for each service. Verify a client’s mental health eligibility with their insurance provider before each session. If you receive a denial, appeal it with solid documentation.
3. Should I use billing software for my mental health practice?
Yes! Using billing software designed for mental health billing services can save you time, reduce errors, and improve your cash flow. It helps you manage claims efficiently and track payments.
4. How do I handle unpaid bills for mental health services?
Be clear with clients about your payment policies upfront. If a bill goes unpaid, send gentle reminders, and offer flexible payment plans. If necessary, consider partnering with a billing company to handle collections.
5. What are the mental health CPT codes I need to know?
Common codes include 90791 (intake), 90834 (45-minute session), and 90837 (60-minute session). Stay up to date with CPT revisions to ensure you're always using the right codes.
6. How do I know if a client’s insurance covers mental health services?
You can check a client’s mental health eligibility directly with the insurance company before the first session. Many providers have portals for quick eligibility checks.
🧘♂️ Let’s Make Mental Health Billing Easier Together
Ready to stop battling the system? Whether you need help with behavioral health billing, CPT codes, or claim rejections, I’ve got your back.
Let’s simplify this process and get you paid.
No comments:
Post a Comment