Key Takeaways Medicare pays for behavioral health integration (BHI) through two models: psychiatric collaborative care (CoCM), billed with 99492, 99493, 99494, and G2214, and general BHI, billed with 99484, or with G0323 when a clinical psychologist or clinical social worker is the treating practitioner. The standalone BHI codes are monthly and time-based, so each claim […]
Behavioral Health Carve-Outs: Why Mental Health Claims Go to the Wrong Payer
Key Takeaways A behavioral health carve-out moves mental health and substance use disorder benefits from the medical plan to a managed behavioral health organization (MBHO), whose name may not appear on the front of the patient’s insurance card. Claims sent to the medical plan for carved-out services typically deny with CARC 109, which signals the […]
The Coding and Billing Mistakes Behind Denied Behavioral and Mental Health Claims
Key Takeaways CPT 90832, 90834, and 90837 are separated by strict, non-negotiable time thresholds. Defaulting to 90837 without matching documentation is a common audit trigger. Standalone psychotherapy codes cannot be billed alongside an E/M code on the same date of service. Add-on codes 90833, 90836, and 90838 exist specifically for combined therapy and medication management […]
The Billing Gap Between Telehealth and In-Office Mental Health Visits
Key Takeaways Telehealth and in-office mental health visits require different place-of-service codes, and submitting the wrong one is one of the most common sources of avoidable denials. Modifier requirements vary by payer — and modifier rules for audio-video telehealth have shifted over time, so assumptions based on older workflows may no longer be accurate. Documentation […]
Top Behavioral Health Billing Companies: How to Choose the Right Partner for Your Practice
Key Takeaways Behavioral health billing requires specialization that general medical billing companies often lack. Payer rules, authorizations, and policy changes directly affect reimbursement outcomes. Telehealth billing expertise is now essential for mental health practices. Clear reporting and proactive denial management support long-term financial stability. The best billing partners function as an extension of your practice. […]
Coding Guidance for Smoking Cessation Counseling
The American Psychiatric Association provides a two-page resource discussing procedure coding for smoking cessation counseling. There are a number of different procedure codes that can be used to describe services provided to encourage changes in behavior of individuals who use tobacco. The resource identifies the CPT and HCPCS codes that describe smoking/tobacco cessation counseling, as […]