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You Focus on Healing. We Handle the Billing.
Mental health billing is uniquely complicated — parity rules, prior authorization battles, session-length-dependent CPT codes, and some of the highest denial rates in healthcare. Theiatrics manages it completely, so you can stay focused on the work that matters.
High Prior Authorization Denial Rates
Mental health prior auths are denied more often than general medical services — often without clear clinical justification, requiring persistent and knowledgeable appeals.
Session-Length CPT Code Errors
Selecting 90834 vs. 90837 depends on documented time — a common, costly mistake that leads to systematic underpayment across hundreds of sessions.
Parity Violations Payers Hope You Miss
Insurers apply session limits and more restrictive documentation requirements to mental health — sometimes in violation of federal parity law. Most providers don't recognize it.
Credentialing Delays That Cost Months
Getting paneled with payers takes 60 to 120 days. During that window, providers bill out-of-network or don't bill at all — losing significant reimbursement.
Time Stolen from Client Care
Every hour spent on claim follow-up and insurance calls is an hour not spent with clients. Mental health providers didn't train for this — and they shouldn't have to do it.
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Optimize Operations for Maximum Efficiency
Contact us to explore how our consulting can position your business as a frontrunner.
The Real Challenge
Mental Health Billing Is Harder Than It Should Be — and Payers Know It
Mental health has always occupied an uncomfortable space in the insurance world. Despite federal parity laws that require equal coverage for mental and physical health, insurance companies continue to find ways to limit mental health benefits — through stricter prior authorization requirements, narrower network panels, more frequent utilization reviews, and documentation standards that create friction at every turn.
The billing side reflects this tension directly. Mental health claims are denied more frequently than almost any other type of medical claim. Prior authorizations are requested more often, documentation requirements are more demanding, and appeals require a different level of clinical and legal knowledge than standard medical billing appeals do.
On top of that, psychotherapy CPT coding depends on session length in a way that creates constant risk of error. The wrong code — even by a single minute of documented time — changes the reimbursement entirely. And for providers who see 6 to 8 patients a day, getting this right across every single claim requires both precision and consistency.
Theiatrics was built for exactly this environment. We understand mental health billing not just as a coding exercise, but as an advocacy effort on behalf of providers who deserve to get paid for the critical care they deliver.
98%
First-pass claim acceptance rate
15-21
Average days to reimbursement
30%
Average revenue increase for new clients
100%
HIPAA compliant — always
WHO WE WORK WITH
Mental Health Billing for Every Provider Type and Practice Setting
Whether your practice independently or lead a multi-clinician group, we build a billing workflow that fits the way you work.
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Licensed Therapists & Counselors
LCSWs, LPCs, LMFTs, and MFTs — we handle billing for individual, couples, and family therapy so you can focus entirely on your clients.
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Psychologists
Testing, assessment, and psychotherapy billing — including 90791 evaluations, psychological testing codes, and ongoing therapy sessions billed correctly by credential.
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Psychiatrists & Psychiatric NPs
Medication management, 90792 evaluations, and combined E/M plus psychotherapy billing — complex claim types that require prescriber-specific coding expertise.
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Group Practices & Multi-Clinician Teams
Consistent billing quality across every clinician on your roster — with group therapy coding, supervision billing, and per-provider reporting built in.
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Community Mental Health Centers
Sliding-scale and grant-funded practices with mixed payer populations — we manage the billing complexity so your mission isn’t undermined by revenue gaps.
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New Practices Getting Started
Getting credentialed with the right payers, choosing your network strategy, and setting up clean billing from day one — we help you build it right from the start.
WHAT WE HANDLE
Complete Mental Health Billing Services, Start to Finish
We manage every step of your billing cycle — from the first benefits check to the final payment — so every session you provide gets fully reimbursed.
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Insurance Verification & Benefits Check
Before a new client’s first appointment, we verify their mental health benefits in full — session limits, deductibles, out-of-pocket, copay, prior auth requirements, and any plan-specific restrictions. Clear expectations from day one.
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Psychotherapy CPT Coding
We select the correct psychotherapy CPT code for every session based on service type, documented time, and provider credential — 90837, 90834, 90832, 90847, 90846, 90853, and others. Accurate from the first claim, every time.
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Prior Authorization Management
We handle prior auth submissions, track active authorizations, and appeal denials with the clinical documentation payers require. Your clients’ treatment stays on track — and so does your revenue.
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Mental Health Parity Compliance & Advocacy
We identify when payers are applying session limits, documentation requirements, or prior auth rules that violate the Mental Health Parity and Addiction Equity Act — and we pursue appeals that put the law on your side.
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Claims Submission & Tracking
Every claim is submitted electronically and tracked from submission to payment. No claim gets lost or silently aged out. Any claim that stalls gets followed up before it becomes a write-off.
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Denial Management & Appeals
Mental health denials require clinical and parity-law knowledge to overturn effectively. We analyze each denial, build a targeted appeal, and follow through until the decision is reversed. Denials are a starting point, not an ending.
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Therapist & Provider Credentialing
We manage paneling applications for LCSWs, LPCs, LMFTs, psychologists, and psychiatrists — from initial application through approval and re-credentialing. Get in-network faster and stop billing out-of-network unnecessarily.
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Telehealth Therapy Billing
Teletherapy billing uses the same CPT codes as in-person sessions with specific place-of-service codes and modifiers. We apply them correctly — and stay current on each payer’s telehealth coverage policies as they continue to evolve.
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Reporting & Revenue Analytics
Monthly reports covering collection rates, denial trends, payer performance, AR aging, and revenue by service type. Know your practice’s financial health clearly — without having to dig through claim portals yourself.
Mental Health Parity
Payers Are Required to Treat Mental Health Like Any Other Medical Service. Many Don't.
The Mental Health Parity and Addiction Equity Act has been federal law since 2008. Understanding it — and using it to fight improper denials — is one of the most powerful tools in mental health billing.
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires that insurance plans offering mental health and substance use disorder benefits cannot apply more restrictive limitations to those benefits than they apply to comparable medical and surgical services. In plain terms: if a plan doesn't require prior authorization for a primary care visit, it generally can't require it for a therapy visit either.
In practice, parity violations are widespread and often subtle — a session limit that doesn't apply to physical therapy, a utilization review process that only applies to mental health claims, or a medical necessity documentation standard more rigorous than any comparable medical service. Most providers accept these practices as the cost of doing business. They shouldn't.
Theiatrics identifies potential parity violations in the denials and restrictions our clients face, documents them, and uses MHPAEA as a basis for appeals. This isn't an edge case strategy — it's a core part of effective mental health billing advocacy that directly recovers revenue that payers are hoping you'll write off.
What This Means for Your Practice
Every time a payer denies a mental health claim for reasons they couldn't apply to a comparable medical service, that's a potential parity violation — and a potential appeal that wins. We know how to identify them and how to make the case.
- Session Limits That Don't Apply to Medical Care If a plan limits therapy to 20 sessions per year but doesn't apply equivalent limits to physical therapy or other ongoing medical treatment, that restriction likely violates parity rules and can be challenged.
- Prior Auth Required for Therapy, Not for Medical When a payer requires prior authorization for outpatient therapy sessions but not for comparable outpatient medical services, that's an imbalance MHPAEA is designed to prohibit — and it's appealable.
- Stricter Medical Necessity Criteria Documentation standards for mental health claims are frequently more demanding than those applied to comparable medical services. When this disparity exists, it creates grounds for parity-based appeals on denied claims.
- Higher Out-of-Network Rates for Mental Health Some plans apply different out-of-network reimbursement rates to mental health services compared to equivalent medical services — another form of parity violation that affects both provider reimbursement and patient cost-sharing.
Coding Expertise
The Right CPT Code for Every Session — Every Time
Psychotherapy CPT coding has a specific structure that catches many providers off guard. Unlike most medical billing, the correct therapy code depends primarily on the length of the session as documented in the clinical note — and the thresholds are precise. A session documented at 52 minutes bills under 90834. A session documented at 55 minutes bills under 90837. A single minute of underdocumentation changes the reimbursement on every claim.
This time-based structure, combined with variations based on provider credential and the presence or absence of medication management, means psychotherapy coding requires specific training — not just familiarity with billing in general. Our coders know these distinctions and apply them correctly on every claim we submit.
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90791
Psychiatric Diagnostic Evaluation Initial evaluation no medical services component
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90792
Psychiatric Diagnostic Eval w/ Medical Services Used by prescribers (MD, NP, PA) includes medication management
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90832
Individual Psychotherapy — 16–37 min Time based documentation must support range
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90834
Individual Psychotherapy — 38–52 min Most commonly under billed often should be 90837
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90837
Individual Psychotherapy — 53+ min Highest reimbursed individual therapy code
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90847
Family Psychotherapy — Patient Present Conjoint therapy with identified patient in attendance
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90853
Group Psychotherapy Billed per patient requires group documentation standards
Getting the CPT code right is only half the picture. Insurance companies require clinical documentation that justifies the service billed — and for mental health, those standards are applied more strictly than in almost any other specialty. Here's what payers typically require to approve and reimburse mental health claims.
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Documented DSM-5 Diagnosis (ICD-10 Code) A specific, current ICD-10 diagnosis code — not just a symptom description — is required for all mental health claims.
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Medical Necessity Justification Documentation showing the diagnosis meets medical necessity criteria — typically including symptom severity, functional impairment, and treatment appropriateness.
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Treatment Plan with Measurable Goals A current treatment plan documenting therapeutic approach, measurable goals, and expected course of treatment — essential for continued authorization.
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Session-Length Documentation Start and end times of the therapy session must be recorded in the clinical note to support time-based CPT code selection.
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Progress Notes Showing Functional Change Ongoing session notes documenting response to treatment, symptom changes, and progress toward treatment goals — required for continued medical necessity.
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Provider Credential & NPI on File Active state licensure, NPI number, and current payer credentialing — verified and kept current so claims don't reject at the credential level.
Why Theiatrics
Mental Health Billing Needs More Than a Generalist Approach
Most medical billing companies will say they handle mental health billing. What they often mean is that they can submit a 90837 and post the payment. That's the floor — not the full picture of what effective mental health billing actually requires.
Real mental health billing means knowing the parity law well enough to use it in appeals. It means understanding why a provider's credential affects which CPT codes are valid. It means recognizing when a payer's session limit is a policy versus a violation. These aren't edge cases — they come up in mental health billing every week, with every payer, for every provider we work with.
Theiatrics has built mental health billing as a defined specialty within our practice. We know the code sets, the parity rules, the documentation standards, and the appeals strategies that produce results in this specific billing environment. That knowledge shows up in collection rates, denial overturn rates, and ultimately in the revenue your practice brings in.
"You built your practice to help people. The last thing it should cost you is sleep over billing."
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Mental Health Billing Specialists Our team trains on psychotherapy coding, parity law, and mental health payer policies — not general medical billing applied to therapy.
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MHPAEA Parity Advocacy We identify parity violations in denials and restrictions, document the disparity, and use it as grounds for appeals that payers can't easily dismiss.
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Time-Based CPT Code Accuracy We apply the session-length thresholds correctly on every claim — protecting your reimbursement and your compliance simultaneously.
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Performance-Based Pricing We collect a percentage of what we recover — so when you get paid more, we earn more. Our interests are completely aligned with yours.
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Works With Your EHR We integrate with SimplePractice, TherapyNotes, Kareo, AdvancedMD, Valant, TheraNest, and most other mental health EHR platforms.
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No Long-Term Contracts Month-to-month only. You stay because the results are good — not because you signed something that made leaving difficult.
Find Out What Your Mental HealthPractice Should Be Collecting
Our free revenue audit looks at your current billing — denial patterns, CPT code accuracy, missed opportunities — and shows you exactly what more precise billing is worth. No commitment, no pressure.
Schedule My Free Audit →COMMON QUESTIONS
Answers to What Mental Health Providers Ask Us Most
We believe in full transparency — no jargon, no runaround.
Have a specific charge entry question? Our specialists respond within 4 hours.
📞 Call Our Charge Team
📞 Call Our Charge Team
What CPT codes are used for mental health billing?
The most common mental health CPT codes are 90837 (individual therapy, 53+ min), 90834 (38–52 min), 90832 (16–37 min), 90847 (family therapy with patient present), 90846 (family therapy without patient), 90853 (group therapy), 90791 (diagnostic evaluation), and 90792 (diagnostic eval with medical services, for prescribers). The correct code depends on session type, documented time, and provider credential.
What is mental health parity and how does it affect billing?
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires insurance plans to cover mental health and substance use services under terms no more restrictive than comparable medical services. In billing, this means payers can't apply stricter prior auth requirements, session limits, or documentation standards to mental health claims than they apply to equivalent medical ones. When they do, it's a violation — and an appealable one.
Why do mental health claims get denied so often?
Mental health claims face denial for several distinct reasons: missing or incorrect CPT codes based on session length, documentation that doesn't meet medical necessity standards, lapsed prior authorizations, credentialing gaps, and payers applying benefit restrictions that may violate parity law. Each denial type requires a different response — which is why specialty billing expertise matters so much in this field.
How do therapists get credentialed with insurance companies?
Therapist credentialing involves applying to individual payers with your state license (LCSW, LPC, LMFT, PhD, PsyD), malpractice insurance, NPI number, and any required supervision documentation. The process typically takes 60 to 120 days per payer. Theiatrics manages the entire credentialing and re-credentialing process so providers get paneled as efficiently as possible.
Can mental health providers bill for telehealth sessions?
Yes. Teletherapy billing uses the same psychotherapy CPT codes as in-person sessions, with place-of-service code 02 or 10 depending on where the patient receives the service, and often modifier 95 or GT depending on the payer. Medicare, Medicaid, and most commercial plans cover teletherapy — though rules vary by payer and continue to evolve. We stay current on all of them.
How quickly can my practice get started with Theiatrics?
Most mental health practices and groups are fully onboarded within 10 to 14 business days. We handle the EHR connection, credentialing review, and billing setup — your clinical team's involvement during the transition is minimal. Claims go out more accurately from the very first submission.
FREE CHARGE AUDIT
Find Lost Revenue Before Claims Are Filed
We review recent encounters, identify missed or undercoded charges, and show exact revenue impact — before you commit to anything.
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⚖️
E/M validation
Codes matched with documentation
Codes matched with documentation
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Revenue impact
Exact dollar value identified
Exact dollar value identified
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24-hour results
From certified specialists
From certified specialists
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No cost, no commitment
100% risk-free audit
100% risk-free audit
Talk to a specialist
(+1) 713-281-4490
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5900 Balcones Drive Ste 7988, Austin, Texas, 78731, USA
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