Free Mental Health Resource: Tips and Strategies for Billing From SPRC

The Suicide Prevention Resource Center (SPRC) provides numerous valuable and free primary care resources on its website.

Included in these resources is a five-page guide on "Tips and Strategies for Billing for Mental Health Services in a Primary Care Setting."

Topics covered in this guide include:

  • How to bill for diagnostic and treatment services
  • Tips for diagnostic and evaluation codes to use in billing for mental health services
  • CPT and HCPCS codes for Medicare and Medicaid payment for mental health services
  • Billing for actual time of service
  • Medical record documentation (recommended principles)

In addition to providing guidance to improve billing success, the guide also identifies a series of links to helpful, web-based information for primary care practices.

Access this guide on mental health billing strategies (pdf).

Note: The guide indicates the Department of Health and Human Services will replace the ICD-9-CM codes with ICD-10-CM (diagnosis) and ICD-10-PCS (hospital procedure) code sets effective Oct. 1, 2014. This date was recently changed and confirmed as Oct. 1, 2015.

While this guide provides some good tips and strategies, it just scratches the surface of what practices need to know to properly bill for mental health services. Mental health professionals provide one of the widest scopes of healthcare services, administering treatment to patients of all socioeconomic groups, and with all types of acute and chronic mental and social health issues. Patients receiving care are just as varied. Services are rendered in multiple facilities. Coverage for diagnosis and treatment undergoes frequent changes and varies widely by state and payor guidelines.

When taking all of these factors into consideration, it is not surprising to learn that many behavioral health professionals struggle to submit clean claims. This is why more practices are outsourcing their billing to a leading mental health billing service provider like PGM Billing. With PGM's mental health billing services, PGM manage all aspects of a practice's billing to help ensure proper, timely compensation is received for services rendered.


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