Skip to main content

Behavioral Health Revenue Cycle

Mental Health Billing Services for Psychiatry, PMHNP & Psychology Practices

End-to-end claims, denials, posting, and A/R follow-up for psychiatrists, PMHNPs, psychologists, and behavioral-health groups nationwide.

Ask the AI Concierge See Pricing

What’s Included

Exactly What You Get.

  • Eligibility and benefits verification, including behavioral-health riders and carve-outs.
  • Claim submission and scrubbing across commercial, Medicaid, and managed-care payers.
  • Prior authorization tracking with expiration alerts before sessions are billed.
  • Denial follow-up worked by payer, code, and provider.
  • Telehealth coding with the correct modifier and place-of-service.
  • Payment posting, adjustment, and patient-balance reconciliation.
  • Aging AR work-down with monthly collections reporting.
  • Provider-level revenue visibility across the panel.

Engagements are scoped in writing — credentialing from $2,500, billing at 6–8% of collections with a monthly minimum (full pricing). Solo therapist or counselor? Skip the sales call and use our self-serve path.

What We Manage

Your Whole Behavioral Health Revenue Cycle.

Claim submission is the last step — most revenue leaks start upstream.

Clean Claim Flow

Claims that go out complete, correctly coded, and on time.

Denial Root-Cause

Patterns tracked by payer, code, and provider — not just resubmitted.

Eligibility & Benefits

Riders and active coverage verified before the visit, not after.

Prior Authorization

Requests filed and expirations tracked so covered sessions get paid.

Payer & Policy Monitoring

Auth rules, fee schedules, and telehealth changes flagged for your mix.

Posting & Reconciliation

Payments and adjustments recorded so your AR report reflects reality.

Revenue Visibility

See Every Claim, Denial, and Dollar.

One dashboard shows what is billed, collected, denied, and sitting in AR — by provider and payer. It is the information you need for staffing, scheduling, and payer-mix decisions, part of full revenue cycle management.

Ask the AI Concierge
AdvanceAPractice revenue cycle dashboard showing claims, denials, and AR

How It Works

Three Steps to a Steadier Cycle.

1

Review

We map your denial rate, aging AR, payer mix, and where claims are stalling.

2

Fix at the Source

We correct the upstream intake, coding, or credentialing gap driving the pattern.

3

Run the Rhythm

Clean claims go out, denials get worked, and you get monthly visibility.

Who We Bill For

Built for Mental and Behavioral Health Practices.

Psychiatry

E/M, psychotherapy add-ons, and prior-auth-heavy payer rules.

PMHNPs & NPs

Medication management, add-ons, telehealth, and supervision billing.

Psychology & Testing

Time-based therapy plus psychological testing and assessment codes.

Group Practices

Multi-provider consistency and panel-wide revenue visibility.

Where Billing Connects

A Recurring Denial Usually Starts Upstream.

FAQ

Mental Health Billing FAQs

What CPT Codes Do Behavioral Health Practices Bill Most?

Common codes include 90791/90792 for evaluations, 90832/90834/90837 for individual psychotherapy, 90853 for group, the add-on codes 90833/90836/90838 with an E/M visit, and 99213/99214 for medication management. The right code depends on the service and what the documentation supports.

Why Do Behavioral Health Claims Get Denied More Often?

Prior-authorization rules, time-based coding, session limits, telehealth modifiers, and credentialing gaps all add denial risk. Most are preventable with a clean front-end process and disciplined denial follow-up.

Do You Bill Telehealth Sessions?

Yes. We use the correct modifier (95 for audio-video, 93 for audio-only) and place-of-service (02 or 10), and keep the rules current as payers change them.

Can You Work With Our Existing EHR?

Yes. We work inside SimplePractice, TherapyNotes, Valant, Kareo/Tebra, AdvancedMD, and others rather than forcing a switch.

Start Here · Improve the Systems Your Team Already Uses

Revenue-cycle work queues that show the next corrective action

The responsible team can separate payer behavior from controllable workflow problems, work the next action, and see aging, repeat causes, and overdue items.

What AdvanceAPractice changes or builds

  • Trace representative transactions through the included eligibility, claim, remittance, posting, and follow-up stages.
  • Configure supported queues, categories, assignments, deadlines, reports, and management checks.
  • Document which correction belongs to staff, the biller, a system administrator, or the payer.

What will be in your hands

  • Denial and payment-resolution tracker
  • Defined cause and next-action categories
  • Management dashboard for aging and recurring issues
  • Ownership, escalation, and weekly-review instructions

Systems we work in

  • Tebra/Kareo billing and revenue-cycle workflows
  • Customer-authorized clearinghouse and payer portals
  • Microsoft 365 — Excel, SharePoint, and Power Automate
  • Command Suite revenue-cycle trackers and dashboards

Platforms we can evaluate or connect

  • Office Ally, Availity, Change Healthcare / Optum, Waystar, TriZetto Provider Solutions, Claim.MD, Apex EDI, Inovalon, ABILITY Network, and Zelis
  • Billing and report capabilities in AdvancedMD, athenahealth, Epic, Valant, TherapyNotes, SimplePractice, and ICANotes
  • Google Sheets, BigQuery, and Cloud Storage for approved reporting or reconciliation designs
  • Supported X12 837, 835, 270/271, 276/277, 277CA, 999, and 834 transaction paths

Supported methods

  • Native reports, work queues, remittance files, and clearinghouse exports
  • Supported APIs, SFTP, webhooks, and structured export or import
  • Controlled reconciliation when a supported automated path is unavailable

Access dependencies

We need authorized access to the included EHR or PM system, clearinghouse, payer response files, current billing workflow, representative transactions, and the person who can approve corrections.