Mental health billing for solo therapists and group practices: psychotherapy time codes, intakes and family sessions, telehealth, behavioral health plans and credentialing, worked inside the software you already use by a US-based team.
Mental health billing services turn every session into a paid claim. Behavioral health benefits are checked before the first session, each session is coded to the time and service the note documents, telehealth goes out with the right place of service and modifier, and every payment, denial and client balance is followed until it is resolved.
86.2%
of improper Medicare payments to clinical psychologists in CMS’s 2025 review were insufficient documentation
92.2%
of improper Medicare payments to clinical social workers were missing or insufficient documentation
Therapy is billed by the clock. A 52-minute session and a 53-minute session are different codes, telehealth has its own place of service and modifiers, and many commercial plans hand behavioral health to a separate company with its own network, authorizations and payer ID. A claim can be clinically sound and still go to the wrong payer.
Nearly every Medicare error in therapy is a documentation error. That is why our billing starts with the note: when it does not support the time or the code, we tell you before the claim goes out, not after it is denied.
Most practices bill commercial behavioral health plans, Medicare and Medicaid, and telehealth sessions in the same week, often for the same client. Each one pays differently and fails in its own way. Here is where each breaks, and what we do about it.
Pays forIntakes, individual, family and group sessions, coded by the minutes documented and the service delivered.
Where it breaks
What we do
Pays forCommercial plans, Medicare and Medicaid, often through a separate behavioral health company with its own network and payer ID.
Where it breaks
What we do
Pays forVideo and, for some payers, audio-only sessions, each with its own place of service and modifier rules.
Where it breaks
What we do
Psychotherapy codes are chosen by time: 90832 for 16 to 37 minutes, 90834 for 38 to 52, and 90837 for 53 minutes or more. Sessions under 16 minutes are not billed as psychotherapy. The time has to be in the note, along with the diagnosis, the treatment plan and what was done in the session.
Since January 2024, Medicare also pays licensed marriage and family therapists and mental health counselors directly, at 75% of the clinical psychologist rate. Every clinician still has to be enrolled with each payer before the first session they bill.
What we do: before a session claim goes out, we check the code against the time and service documented. If the note is missing time or does not support the code, we tell you the same day, rather than send a claim the note will not support.
These are the codes behind most therapy claims, and what payers look for on each one. Medicaid and behavioral health plans add their own rules, and we check each one.
| Code | What it covers | What payers look for |
|---|---|---|
| 90791 | Psychiatric diagnostic evaluation (intake) | One per intake; not billed with psychotherapy codes on the same day. |
| 90832 | Psychotherapy, 30 minutes | 16 to 37 minutes documented. |
| 90834 | Psychotherapy, 45 minutes | 38 to 52 minutes documented. |
| 90837 | Psychotherapy, 60 minutes | 53 minutes or more documented. Some plans review it more closely. See our mental health insurance billing guide. |
| 90785 | Interactive complexity, add-on | Only with the specific factor that made the session complex documented. |
| 9084690847 | Family psychotherapy, without and with the client | At least 26 minutes, with who attended documented. |
| 90853 | Group psychotherapy | Per client in the group, with the session documented in each record. |
| 9083990840 | Psychotherapy for crisis, first 60 minutes and each additional 30 | At least 30 minutes, with the urgent assessment and crisis interventions documented. |
| 96127 | Brief emotional or behavioral assessment | Per standardized instrument, scored and documented. |
| H0004H2019 | Medicaid behavioral health codes, examples | HCPCS codes some state Medicaid programs use in place of CPT, with state-specific units and modifiers.MedicaidRules vary by state. |
A synchronous audio-video session, where the payer requires the modifier.
A session by phone, only where the payer covers audio-only and asks for the modifier.
Place of service 10 when the client is at home, and 02 when they are somewhere else, as each payer requires.
An older telehealth modifier some Medicaid and commercial plans still require in place of 95.
Education-level modifiers some state Medicaid programs require to show who provided the service.
A second service that is separate from another billed the same day, used only when the note shows it. Our modifier 59 guide
Sources: CPT psychiatry guidelines; CMS place of service code set; state Medicaid behavioral health manuals; CMS 2025 improper payment data. CPT is a registered trademark of the American Medical Association; the descriptions above are summaries. Reviewed October 2026.
It is not for every practice. If you run a private-pay practice that gives clients superbills to file themselves, you need a good superbill, not a billing service. And if your in-house biller keeps denials low and receivables current, keep them, and consider a periodic billing audit instead.
We look at your clean-claim rate, your denials by payer and reason, session codes against documented time, telehealth billing, and your aging receivables, and tell you what we find, whether or not you go further with us.
We get access to your practice management system and clearinghouse, load each plan's behavioral health and telehealth rules, list each clinician's credentialing status, and agree how escalations work. Most practices are live within one to two weeks.
Sessions are coded and claims submitted within 24 hours. Rejections are corrected the same day, remittances posted as they arrive, authorizations tracked, and denials worked to their cause, all inside your system.
A report you can read in ten minutes: what was billed and collected by payer and clinician, what was denied and why, authorizations close to running out, and what is aging.
You do not change systems to work with Summit Billing Solutions. We work in the practice management and EHR systems below, and through the clearinghouse you already use. If your practice management software is not shown, ask; the list grows as we onboard practices.
2%
Average claim rejection rate
24 hrs
Claims submitted within
28
Average days in A/R
Handling mental health billing can be tedious and detail heavy, but this team has made the entire process remarkably smooth. They process claims efficiently, stay on top of communication, and consistently keep us informed before we even need to ask.
I had an outstanding experience with this medical billing company. Their thoroughness and attention to detail gave me confidence that everything was handled correctly from start to finish.
Most billing companies charge a percentage of what they collect; some charge a flat monthly fee or a per-claim rate. For a mental health practice, a percentage usually fits best: the company is paid when you are paid, so the incentive sits where it belongs.
Summit Billing Solutions charges between 3% and 9% of monthly collections. What moves the number for a mental health practice is session volume, the number of clinicians and plans, how many plans carve out behavioral health or require authorizations, and how clean the receivables are when we take them on, which is why we quote your exact rate after the free account review, not before.
3% to 9%
of monthly collections
We bill for more than 40 specialties, for practices in all 50 states, from Salem, New Hampshire. Each one has its own codes, modifiers and payer rules.
A free account review looks at your clean-claim rate, your denials by payer and reason, session codes against documented time, telehealth billing and your aging receivables, and tells you what we would change. No cost, no obligation, and no pressure to continue. What the review covers, step by step, is on the free account review page.
50A Northwestern Drive, Salem, NH 03079
603-207-3172
(866) 906-3116
info@summitbillingsolutions.com
Mon - Fri @ 9am - 5pm
As a mental health provider, having a reliable billing partner is essential, and Summit Billing Solutions has exceeded my expectations. Their team is professional, knowledgeable, and incredibly responsive.