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Behavioral health billing for practices and agencies
Billing for outpatient mental health practices, community behavioral health agencies and group programs.
How behavioral health billing works
Behavioral health billing mixes two worlds. Individual therapy and psychiatry use CPT codes such as 90791 and 90837, while many state Medicaid programs pay community services with HCPCS H- and T-codes (for example H0031, H0036, H2011, H2014 and T1017), each with its own unit size, modifiers and service definitions.
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Many commercial and Medicaid plans also carve behavioral health out to a separate managed behavioral health organization, so the payer on the insurance card is not always the payer that processes the claim.
Codes we bill every day
| Code | What it covers |
|---|---|
| 90791 | Psychiatric diagnostic evaluation without medical services |
| 90832 / 90834 / 90837 | Psychotherapy, about 30, 45 and 60 minutes |
| 90846 / 90847 | Family psychotherapy without and with the patient |
| 90853 | Group psychotherapy |
| 90839 / 90840 | Psychotherapy for crisis, first 60 minutes and each added 30 |
| H0031 / H0032 | Mental health assessment and service plan development (Medicaid) |
| H0036 | Community psychiatric supportive treatment (Medicaid) |
| H2011 | Crisis intervention service, per 15 minutes (Medicaid) |
| T1017 | Targeted case management, per 15 minutes (Medicaid) |
Code descriptions are summarized. Payer coverage and documentation rules vary by plan and state.
Denials we prevent
- Services billed to the medical plan when behavioral health is carved out
- Session time that does not support the psychotherapy code billed
- Missing or exceeded authorizations for Medicaid community services
- Wrong rendering provider type or missing supervising provider
- Units that exceed state Medicaid limits per day
Payer rules to watch
State Medicaid programs define which provider types can bill each H-code, what documentation is required and how many units are allowed. We map your services to your state’s service definitions before the first claim goes out.
Questions about behavioral health billing
Do you bill community mental health services under Medicaid?
Yes. We bill state Medicaid H- and T-code services for agencies, including case management, community support and crisis services, following each state’s definitions.
Do you handle carve-out behavioral health plans?
Yes. We identify which organization processes behavioral health claims for each plan and submit to the right one.
Get a free behavioral health billing audit
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.