How do you handle billing when a psychiatrist sees a patient for both medication management and therapy?

We bill the appropriate E/M code for the medication management visit plus the applicable psychotherapy add-on code (90833, 90836, or 90838 depending on therapy time). Both services must be separately documented to support both charges.

What documentation is required for psychotherapy time-based codes?

The clinical note must document the start and stop time of the psychotherapy (or total minutes) along with the content of the session. We review documentation requirements with your providers to prevent time-documentation denials.

Do you handle telehealth billing for behavioral health services?

Yes. We bill behavioral health telehealth services with the correct POS code, telehealth modifiers (GT or 95), and platform-specific requirements for each payer — including keeping current on Medicare telehealth flexibilities and state Medicaid telehealth rules.

How do you manage prior authorization for ongoing therapy patients?

We track the authorized session count for each patient and submit renewal requests proactively — before the authorization limit is reached. We also document the medical necessity rationale needed to support extended authorization requests.

Can you handle billing for group therapy alongside individual services?

Yes. Group therapy (90853) has its own documentation requirements and is billed separately from individual psychotherapy. We track both and ensure the notes support the type and duration of each service billed.

Specialty Billing

Mental Health & Behavioral Health Billing

Accurate, compliant billing for psychotherapy, psychiatric services, and collaborative behavioral health care.

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Mental Health Billing Overview

Mental health and behavioral health billing operates under a distinct set of rules that differ significantly from the rest of outpatient medicine. Psychotherapy services are time-based — the exact minutes spent must be documented and must match the CPT code selected. The combination of an E/M visit and a psychotherapy add-on on the same day requires specific documentation to support both charges. Prior authorization for ongoing therapy is common, appeal windows are strict, and state-specific Medicaid behavioral health rules add another layer of compliance complexity. At 2 Lee's Billing, we specialize in behavioral health billing — from individual and group therapy to psychiatric evaluation, medication management, and collaborative care programs — ensuring compliant, complete billing that protects your practice and maximizes your reimbursement.

Coding Highlights

✓Psychotherapy: 90832 (30 min), 90834 (45 min), 90837 (60 min)
✓Psychiatric evaluation: 90791 (no E/M), 90792 (with E/M)
✓E/M + psychotherapy add-on: 90833/90836/90838
✓Group psychotherapy: 90853
✓Crisis intervention: 90839 (first 60 min), 90840 (add-on 30 min)
✓Collaborative Care Management: 99492, 99493, 99494
✓Telehealth behavioral health codes and platform-specific requirements

Common Mental Health Billing Challenges

Time-Based Billing Documentation

Psychotherapy codes require documentation of the exact start and stop time — or total minutes of psychotherapy. Missing or vague time documentation is the primary cause of behavioral health claim denials.

Prior Authorization for Ongoing Therapy

Most commercial payers require prior authorization for mental health services and re-authorization after a set number of sessions. Missing authorizations or failing to obtain renewal authorizations results in denied claims.

Mental Health Parity Compliance

Under the Mental Health Parity Act, payers cannot apply more restrictive coverage criteria to mental health than to medical/surgical services. However, parity violations still occur — and appeals can recover wrongly denied claims.

Telehealth Billing Complexity

Behavioral health is one of the most common telehealth service categories, but telehealth billing requirements vary significantly by payer — including platform certification, geographic restrictions, and code-specific rules.

Same-Day E/M and Psychotherapy

When a prescriber provides both medication management (E/M) and psychotherapy on the same visit, billing both requires specific documentation to justify the psychotherapy add-on as a separately identifiable service.

Medicaid Behavioral Health Rules

State Medicaid programs often carve behavioral health services into separate managed care plans with their own billing requirements, credentialing processes, and claims submission rules.

How 2 Lee's Billing Supports Mental Health Practices

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Accurate Time-Based Billing

We review session notes for documented therapy time and select the correct CPT code — applying the 8-minute rule for add-on codes and flagging documentation that doesn't support the time billed.

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Prior Authorization Tracking

We track authorization limits for every active patient and submit renewal requests before sessions exceed authorized amounts — preventing mid-treatment claim denials.

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Telehealth Compliance

We apply the correct telehealth codes, modifiers, and place of service designations for each payer — staying current on frequently changing telehealth billing rules.

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Same-Day Combination Billing

We correctly bill the E/M and the psychotherapy add-on when both are documented — ensuring your time and services are fully captured without triggering payer review.

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Mental Health Parity Appeals

When payers deny or limit coverage in ways that may violate mental health parity rules, we prepare and submit appeals citing the applicable federal and state parity requirements.

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Medicaid BH Enrollment & Billing

We handle Medicaid behavioral health enrollment and billing — including carve-out plan requirements, encounter reporting, and state-specific documentation rules.

Mental Health Billing FAQs

Related Services

Medical Billing & Coding Verification of Benefits Denial Management Credentialing & Enrollment

Other Specialties

Primary Care Internal Medicine Pediatrics Family Medicine

Behavioral Health Billing Done Right — Compliant and Complete

Our team understands time-based billing, telehealth rules, and parity compliance. Schedule a free consultation today.

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Or call us: (702) 478-8115 · Toll Free: (800) 364-1801