Time-based services
Many psychotherapy services are reported by session length, so the time documented in the note has to line up with what is billed.
Behavioral health specialty
Mental and Behavioral Health Billing Services
Behavioral health practices bill recurring, often time-based sessions against benefits that can be administered separately, limited by visit counts, or tied to authorizations. All State RCM supports psychiatry, psychology, counseling, and therapy practices with benefit checks, claims, telehealth billing, credentialing, and denial follow-up, within a scope agreed before work begins.
All State RCM
Behavioral Health Billing
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Who we support
Built for behavioral health practices.
Behavioral and mental health billing is a core part of our work. Support is scoped for the way each practice runs, whether that is a solo therapist billing a handful of payers or a multi-clinician group with several locations.
Practice types we can support include:
- Psychiatry practices, including psychiatrists who combine medication management with therapy
- Psychology practices and testing-focused groups
- Counseling practices and individual therapists
- Multi-clinician therapy groups
- Behavioral health practices and outpatient programs
- Telehealth-focused behavioral health providers
Why behavioral health billing works differently.
The claim cycle is the same as in other specialties, but the details that cause rework are not. These are the areas that tend to need closer attention. How much each one matters depends on your payers and services.
Recurring visits
Patients are often seen weekly or every other week. A small coverage or eligibility problem can repeat across many sessions before anyone notices.
Separate benefit structures
Some health plans administer behavioral health benefits separately from medical benefits, sometimes through a different organization with its own rules and contacts.
Visit limits and authorizations
Depending on the plan and service, there may be session limits, authorization requirements, or reauthorization dates to track.
Telehealth sessions
Many practices see some or most patients by video. Telehealth coverage and billing requirements vary by payer and have changed over time.
Payer differences
Commercial plans, Medicare, and Medicaid programs can treat the same behavioral health service differently, including which clinician types they enroll.
Before the session
Eligibility, benefits, and authorization.
Many behavioral health denials start before the first session. Checking benefits up front, and again when coverage or the plan year changes, helps the practice and the patient know what to expect.
Depending on the plan, a benefit check may confirm:
- Active coverage and the plan’s behavioral health benefits
- Whether behavioral health is administered by a separate organization
- In-network status for the rendering clinician
- Copays, deductibles, and coinsurance for the service type
- Visit limits that apply to the plan year
- Authorization requirements, approved visit counts, and end dates
Where a plan requires authorization, we can track approved visit counts and end dates so reauthorization requests go out before sessions run past them. Requirements differ by payer, plan, and service, so they are checked rather than assumed. Clinical information for an authorization request comes from the treating clinician.
Documentation and coding
Documentation and coding review.
A claim is only as strong as the note behind it. For time-based services, that means the documented session time needs to support the service billed. For visits that combine medication management with therapy, both parts need to be documented clearly.
Our medical coding review checks the codes, modifiers, and claim details against the documentation before claims go out, and flags claim edits that commonly lead to rejections. Clinicians remain responsible for documentation and clinical decisions; coding questions that need their input go back to them through an agreed path.
Credentialing behavioral health providers.
A clinician generally needs to be enrolled with a payer before billing it as an in-network provider, and behavioral health groups often add licensed therapists as they grow. Payer enrollment rules for licensed counselors and therapists vary, and they change: CMS states that since January 1, 2024, marriage and family therapists and mental health counselors may enroll in Medicare and bill Medicare independently.
Clinicians
Credentialing support for
- Psychiatrists
- Psychologists
- Licensed clinical social workers (LCSWs)
- Licensed professional counselors (LPCs)
- Licensed marriage and family therapists (LMFTs)
Within agreed scope
What the work can include
- Payer enrollment applications and follow-up
- CAQH profile setup, updates, and re-attestation reminders
- Practice location, contact, and demographic updates with payers
- Recredentialing and revalidation tracking
- Adding clinicians to an existing group or location
Payers make credentialing and enrollment decisions and set effective dates, so no approval or timeline is guaranteed. See our provider credentialing services, or our CAQH profile guide for how profile updates and re-attestation work. Medicare enrollment detail: CMS, Medicare & Mental Health Coverage (MLN1986542, March 2026).
Telehealth
Telehealth billing support.
Telehealth is a routine part of many behavioral health practices. For Medicare, CMS describes telehealth coverage for behavioral and mental health as permanent and allows a patient’s home as the location for certain mental health services. Commercial plans and Medicaid programs set their own telehealth rules, and those rules have changed more than once.
We work telehealth claims inside the same billing workflow: confirming that the patient’s plan covers the service by telehealth, checking that the claim details match how the visit was documented, and reviewing payer requirements as they change instead of applying one rule to every plan.
Source: CMS, Medicare & Mental Health Coverage (MLN1986542, March 2026).
Denial prevention and follow-up.
Because sessions recur, one unresolved cause can produce a denial on every visit until it is fixed. Behavioral health denials often trace back to a few sources:
Eligibility and coverage
Inactive coverage, the wrong payer on file, or a behavioral health benefit administered somewhere else.
Authorization
Sessions billed without a required authorization, after approved visits run out, or after an authorization end date.
Coding and documentation
A billed service or session length that the note does not support, or code combinations a payer does not accept.
Provider enrollment
A clinician who is not yet enrolled with the payer, or enrollment details that do not match the claim.
Demographics and claim data
Patient, subscriber, or practice information that does not match payer records.
Timely filing
Claims or corrections that reach the payer after its filing deadline.
Each denial is reviewed for its cause, then corrected, resubmitted, or appealed where the record supports it, and followed up before filing deadlines. Repeat causes are reported back so the practice can fix them at the source. Learn more about our denial management services.
Patient balances
Patient responsibility.
Copays, deductibles, and coinsurance apply to every session, so patient balances can build quickly over a course of treatment. Clear numbers up front make conversations about cost easier for both the practice and the patient.
Benefit checks show what the patient is likely to owe per session. Accurate payment posting then keeps each balance current, so the practice can see what is open across recurring visits and address it early rather than at the end of a treatment episode. How the practice collects balances stays its own decision.
Visibility
Reporting and revenue cycle visibility.
Reporting is agreed during onboarding and delivered at a set cadence, so the practice can see what is in progress, what is unresolved, and what needs its input.
- Denial trends by reason, payer, clinician, and location
- A/R aging and the next action on open balances
- Payer turnaround and follow-up status
- Collections against charges over time
- Authorization and credentialing items that need practice input
- Recurring workflow issues behind repeat rework
Open balances are worked through our accounts receivable follow-up, and broader workflow reviews are available through audit and reporting.
What we confirm before starting.
Every behavioral health practice runs differently, so we review how yours works before proposing a scope. The review covers:
- Practice type and the services you provide
- Provider mix, including psychiatrists, psychologists, and licensed therapists
- Number of locations, and whether you see patients in person, by telehealth, or both
- Payers you participate with, and any out-of-network billing
- Your EHR or practice-management system and current workflow
- Credentialing and enrollment status for each clinician
- Which billing tasks move to us and which stay with your team
- How authorizations are requested and tracked today
- Current denial patterns and the condition of open A/R
The result is a written scope listing included tasks, practice responsibilities, access, and reporting. Protected health information is handled through approved workflows and applicable agreements.
Pricing
How pricing is determined.
We do not publish a fixed rate for behavioral health billing. Each quote is prepared after reviewing the work involved, and the pricing structure is confirmed in a written proposal before work begins.
Factors that shape the quote include:
- The services included in the scope
- Specialty workflow, such as authorization tracking or telehealth volume
- Number of clinicians and locations
- Monthly claim volume
- Credentialing and enrollment needs
- Any existing A/R or denial backlog
Questions behavioral health practices ask.
01 Do you support mental health billing?
Yes. Mental and behavioral health billing is a core part of our work. Support can include benefit verification, charge entry, claim submission, payment posting, denial follow-up, A/R work, and reporting. The specific tasks are agreed in writing before work begins.
02 What types of behavioral health practices do you work with?
We support psychiatry, psychology, counseling, therapy, and broader behavioral health practices, including telehealth-focused providers. Scope is set for each practice based on its services, clinicians, payers, and systems.
03 Can you help with credentialing for therapists?
Yes. We assist with payer enrollment and credentialing for psychiatrists, psychologists, LCSWs, LPCs, and LMFTs, including applications, follow-up, recredentialing, and demographic updates. Payers make enrollment decisions and set effective dates, so timelines vary.
04 Can you help maintain CAQH profiles?
Yes. CAQH upkeep can include profile updates, document reviews, and re-attestation reminders. The clinician remains responsible for attesting that the information is accurate.
05 Do you support telehealth billing?
Yes. We work telehealth claims as part of the billing workflow, including confirming coverage and checking that claim details match the visit documentation and current payer requirements. Telehealth rules vary by payer and change over time, so they are reviewed rather than assumed.
06 Can you help with behavioral health claim denials?
Yes. Denials are reviewed for their cause, such as eligibility, authorization, documentation, or enrollment, then corrected, resubmitted, or appealed where the record supports it. Repeat causes are reported so they can be addressed upstream. Payer decisions determine the outcome.
07 Can we keep some billing tasks in-house?
Yes. Some practices hand off the full billing workflow; others outsource specific functions, such as credentialing, authorization tracking, or denial follow-up. Each handoff is documented so every task has a clear owner.
08 How is pricing determined?
Pricing depends on the services included, specialty workflow, number of clinicians, claim volume, and agreed scope. We do not publish a fixed rate; the pricing structure is confirmed in a written proposal before work begins.
Free consultation
Talk through your practice’s billing.
Tell us about your clinicians, payers, telehealth mix, and where billing or credentialing work is falling behind. We can walk through your current setup and what a handoff would involve. Please leave patient information out of the form.
Request a Free Consultation
Start a conversation
Let’s strengthen your revenue cycle.
Tell us where your billing workflow needs attention. We’ll discuss your practice, priorities, and the support that may fit.