Mental Health Medical Billing 1
                     
How Is Mental 
Health  Billing 
Different?
Table Session Length
Limits to Appointments  
OF  Different Treatment 
Plans  Pre-Authorizations 
Content  Telehealth
Out-of-Network 
Providers
Billing and Reimbursement for Mental Health Billing 
Services
In the last few years, the concern posed by mental health has taken center stage, mainly after 
the  pandemic.Covid-19 Despite the increase in awareness about mental health issues, the 
practices of the  field face not only 23 percent less reimbursement than primary care but also 
remain under-supported  and overwhelmed with the billing and reimbursement process.
Several factors make mental health billing difficult to handle for the practices. The challenging 
billing  rules often result in therapists refusing to accept the insurance because many payers 
pose limitations  and restrictions on the claims. That’s why mental health usually requires a 
nuanced plan of treatment.  For instance, billing a therapy session is not as straightforward as an 
annual lab test or wellness check.  Let’s see what all involves the mental health billing concerns:
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How Is Mental Health Billing 
Different?
Session Length
In most primary care practices, the bill is done on services based on the CPT code. However, in mental 
health  billing, the codes vary based on the time taken during the visit. For instance, a code for 30 minutes, 
i.e., 90832, can  be used for a session between 16 and 37 minutes. Whereas code 90834 is used for a 
therapy session of 45  minutes, which can be implemented for psychotherapy that takes between 38 and 42 
minutes. Typically, the  closest code is used, bearing the time the patient spends in therapy.
Limits to Appointments
Every insurer allows a limited number of sessions to an individual for mental health within a certain 
period. It is  essential to know the number of limits set by the insurer so they do not exceed and there is 
no chance of claim  rejections or denials.
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Different Treatment Plans
Mental health is a specific field where care plans are customized per 
the  patient’s requirement. Often the treatment plans are more 
intricate, which  makes the billing more complicated.
Pre-Authorizations
A visit to a mental health facility might not need a pre-authorization.  
However, any testing, therapy, or medication would require pre-  
authorization from the insurer. The approval by the insurer varies 
and is  based on the service required by the patient.
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Telehealth
COVID-19 has increased the provision of providing mental health services via 
telehealth. The  bill may use the CPT codes, but the correct modifier is required 
to ensure service  reimbursement. The modifier 95 needs to be added when the 
interaction is live instead of  recording. 02 modifier shows the point-of-service. 
Apart from these, there are different  codes for telemedicine billing in mental 
health that starts with the letter ‘G.’ Also, HCPCS  telehealth codes can be used 
for correct billing.
Out-of-Network Providers
At times, mental health service providers can be out-of-network. Hence, they use 
superbills  to collect the payment. When superbills are submitted correctly, 
they can accelerate the  reimbursement, and service providers can also use 
them to stay in business without joining  the insurance panel.
www.247medicalbillingservices.com [email protected]
About 24/7 Medical Billing 
Services:
24/7 Medical Billing Services is the nation’s leading medical billing service provider catering 
services to  more than 43 specialties across the entire 50 states. You can rely on us for end-
to-end revenue cycle  management. We guarantee up to 10-20% increase in the revenue 
with cost reduction of your practice  for up to 50%.
Call us today at 888-502-0537 to know more on how we can help boost profitability for your 
practice
Media Contact –
24/7 Medical Billing 
Services,  28405 Osborn 
Road,
Cleveland, OH, 44140
Tel: + 1 -888-502-0537
Email: 
info@247medicalbillingse
rvices.com
Website: 
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