What Mental Health Billing Services Cost

What Our Billing Costs And Covers

Ongoing Billing is priced by practice size, from 7% of collections for a solo provider down to 4.5% for 26 or more providers, or by your monthly collections when that rate is lower. There’s no setup fee, a newly added provider has no minimum for their first 90 days, and the rate drops half a percentage point when we also handle your credentialing.

The percentage covers claim scrubbing and submission, rejection and denial follow-up, payment posting and adjustments, A/R follow-up, reconciliation, and reporting. Eligibility and benefits verification and prior authorization aren’t in it. They need a separate written scope. Credentialing is priced on its own, per provider and per payer, so it isn’t buried in the percentage.

Already sitting on a stack of denied or unpaid claims? That’s a different job, and it’s priced a different way. With Billing Cleanup And A/R Recovery, we work your unpaid claims older than 90 days and you pay 20% of what we collect on them. If a claim never pays, you owe nothing on it.

The full service, from claims to the owner report, is on our mental health billing services page.

What The Market Charges

Billing companies price three main ways: a percentage of collections, a fee per claim, or a flat monthly fee, which Checkpoint EHR puts at $500 to $2,000 a month depending on services and practice size. We compare the other two below, plus the fees around them.

Percent Of Collections: Roughly 4% To 10%

Checkpoint EHR calls this the most common model and puts it between 4% and 10% of monthly revenue. Tebra’s guide for billing companies quotes the same 4% to 10% band, and in Tebra’s survey, 24.5% of billing companies using this model charged 6% to 7% in 2022. Our Ongoing Billing, at 7% down to 4.5%, sits inside that range.

Watch the base, though. The rate means nothing until you know what it’s multiplied by. One therapist billing service publishes 6.5% to 8% of the contracted rate or allowed amount of each claim it helps collect, which counts the patient’s share along with the insurer’s payment.

Per-Claim Pricing: Roughly $2 To $10 Per Claim

Checkpoint EHR puts per-claim pricing at $2 to $8. Tebra says many services quote $3 to $10, and describes the model as billing for every submitted claim, whatever the outcome. So a denied claim still costs you, and a low-paying claim costs the same to bill as a high-paying one.

Monthly Minimums And Setup Fees

Minimums are a floor for slow months. GetPracticeHelp’s 2026 cost guide puts a typical monthly minimum at $300 to $500. Setup fees vary more. Checkpoint EHR says some billers charge $200 to $500 upfront to onboard a practice, GetPracticeHelp puts the typical range at $300 to $1,500 per provider or a flat group fee of $1,400 to $1,900, and some services don’t charge anything to start. We don’t charge a setup fee. Our monthly minimum depends on practice size, a newly added provider has none for their first 90 days, and the example below shows when a minimum kicks in.

A Worked Example

Example only. A solo provider collects $40,000 in a month. At 7%, the Ongoing Billing fee is $2,800, and since that’s above the monthly minimum, the bill is $2,800. In a slow month the same provider collects $6,000. Seven percent of that is $420. If that lands below the monthly minimum for your practice size, the minimum applies instead.

Whichever company you’re weighing, ask them to run this math on your last few months before you sign.

What Moves The Price

A billing quote is an estimate of how much work your claims will take. Here’s what changes it.

Payer Mix

Every payer brings its own rules. Behavioral health may be carved out to a separate vendor, and place of service and modifier expectations differ between plans and change between years. A practice billing Medicare, Medicaid managed care and several commercial plans has far more to keep straight than one billing two commercial payers.

Claim Volume

A therapy caseload produces a steady run of psychotherapy claims, 90834 and 90837. Psychiatry and PMHNP practices mix 99213 and 99214 visits with add-on codes like 90833. Per-claim pricing grows with the number of claims. A percentage grows with the dollars. Know which one your practice produces more of before you compare quotes.

A Denial Backlog

Ongoing billing is priced for the claims going out now. Old denials and aging A/R are a different job, so ask how a company prices them. Ours is Billing Cleanup And A/R Recovery. We work the unpaid claims older than 90 days, and you pay 20% of what we collect on them. Claims that never pay cost you nothing.

Credentialing Status

Providers billed before enrollment is active drive avoidable denials. When a denial says the provider isn’t on file, look at enrollment before coding. The rendering NPI may never have been linked to the group’s billing NPI at that payer. Credentialing is priced separately, per provider and per payer.

Your EHR

We work inside SimplePractice, TherapyNotes, Valant, Kareo/Tebra, AdvancedMD and others, so you don’t have to switch. If a biller works in a platform you don’t already have, Checkpoint EHR notes you may need to pay for access or integrate your current EHR.

Who Works A/R

Decide who chases unpaid claims before you compare quotes. Our Ongoing Billing includes A/R follow-up. Elsewhere, check what the base fee actually covers; Checkpoint EHR cautions that denial work, credentialing or benefits checks can cost extra. If your staff will keep part of the work, write down which part, so nobody assumes the other side has it.

Questions To Ask Any Billing Company

• Is the percentage figured on collections, on charges, or on the allowed amount?
• Is there a monthly minimum, and is it per provider or per practice?
• Is there a setup or onboarding fee, and what does it cover?
• Which of these are in the base fee: denial follow-up, appeals, A/R follow-up, payment posting, eligibility checks?
• How is old A/R priced, and who decides which claims are worth working?
• Do you work inside our EHR, or do we need your platform?
• What does the monthly report show? Can we see denials by payer, code and provider?
• What happens to our data and open claims if we leave?