A Complete Guide To Mental Health Billing 2023

We are in a world that never sleeps, where individuals live in constant stimulation. Today, people are busier than ever. The abundance of opportunities leading to exponential growth is a boon for mankind. But collectively the population is experiencing two extremes. The gift of productivity comes with a bane of increasing mental health issues. Here mental healthcare services come into play and help individuals fight their way to healing.

It is not just the patients who need attention, but also healthcare providers who deserve a life free from stress. But what is the reason for their stress? The simple answer to this question is – the process of demanding medical billing process. ‘Mental Health Billing’, if not done properly, causes a significant amount of revenue loss to healthcare providers.

For a mental care provider, focusing on medical billing is as important as delivering quality patient care. This involves facing a wide range of intricacies in this domain, which is now made easy by this blog. By the end of this blog, you will have a complete insight into mental health medical billing.

An Overview Of Mental Health Billing

The long-term success of a healthcare practice depends on understanding the nuances of medical billing. However, the process is complete only with effective implementation to maintain the revenue cycle. The performance of administrative tasks directly correlates with the compensation of mental health practitioners. The billing process initiates with analyzing insurance coverage and progresses through various important steps to attain reimbursement.

Let us look at the vital steps in the mental health billing process:

Insurance Coverage

Insurance policies are complex. It is important to look through coverage limitations and reimbursement rates beforehand.

Pre-Authorization

Certain healthcare services require pre-authorization to ensure that treatment is medically necessary. Therapists need to adjust their care plan according to this requirement.

Medical Coding

There is no cheat code for accurate CPT codes. In usual situations, they are the sole contributors to rejected and denied claims. It is important to code the services with precision for complete reimbursement.

Claim Submission

To receive appropriate revenue, practitioners need to submit claims on time. Delays in the process hamper the financial posture of healthcare practice.

Follow Up Procedure

The process ends with a follow-up procedure where all the rejected claims are reviewed to rectify and re-file them. This step prevents any further loss of revenue.

After a brief overview of mental health billing, it is time to find out the different types of Mental health services.

Different Types Of Mental Health Services

Group Therapy

It is a type of interactive treatment where a group of patients join to seek therapy. This therapy is done to create behavioral patterns in the patients. Group therapy can be reimbursed if the diagnoses are curable.

Family Therapy

This therapy is for the immediate family members or the caregivers of the patients. They are taught to take care of the patient based on their mental health difficulties. During this type of therapy session, the patient’s presence is not required. However, reimbursement under this type is infrequent.

Psychiatric Diagnostic Evaluation

The psychiatric diagnostic evaluation assesses a patient’s mental health. It is also commonly referred to as psych evaluation. It basically examines the behavior, process and cognitive skills of the patient. However, the treatment is given only if the patient is ready to receive it.

Psychotherapy

Psychotherapy or individual therapy is to diagnose anxiety, depression, stress, addiction etcetera. The process for this evaluation involves interactions with the therapist to identify the emotional or behavioral difficulties.

The process of Mental health billing is essential and streamlining it comes with multiple challenges. To tackle such challenges, here is a list of tips to improve your medical billing.

Tips To Improve Mental Health Billing

• Start with the very basics and ensure that patient information is authentic. Couple the authenticity with accurate recording to avoid mistakes. It is better to recheck before finalizing so as not to miss any important details. Along with that, keep an eye out for pre-authorization needs and modifications if any.


• It is crucial to verify the benefits of your service based on the insurance coverage and the types of treatment provided. This proactive step keeps denied and unpaid claims at bay. Also, this step enhances the workflow of the operations.


• Don’t skip any of the steps in the mental health billing process to ensure timely and complete reimbursement. Properly submitted claims have less denial and rejection rates. Align your billing format with the terms of the insurance company and follow submission guidelines for best results.


• Know your CPT codes as they are the most vital part of mental health billing. A wrong CPT code will drastically impact the financial stability of your practice. Correct ICD and CPT code for your specialty is not the only requirement. Don’t let under-coding or over-coding hamper your revenue cycle.


• Handling this task on your own is challenging and that is why outsourcing a partner can reduce your burden with customized services. So, partner with a medical billing service proficient in mental health billing.

The mental billing process is challenging but it is not impossible. Eminence RCM understands the fact that your mental health billing is equally important as the mental health of your patients. Hand over your billing and coding processes to the experts and reduce your administrative load.