Psychiatry is a unique medical field focused on diagnosing, treating, and managing mental health conditions. Unlike other specialties, psychiatric services often involve time-based coding, therapy sessions, medication management, and frequent follow-ups — each with its own billing challenges.

At Progressive RCM, we understand the distinct complexities of psychiatry billing. From ensuring compliant documentation to applying the correct CPT and ICD-10 codes, our services are designed to help psychiatrists and behavioral health providers get paid accurately and quickly.

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The Challenges of Psychiatry Billing

Psychiatric billing is not as straightforward as other medical billing. Mental health billing is governed by strict payer rules, frequent authorization requirements, and time-based session codes that can be tricky to manage.

Here are common challenges:

1. Time-Based Coding
   Psychiatric evaluations and therapy are often billed by the number of minutes spent with the patient. Incorrect use of time modifiers or session lengths can lead to denials.

2. Telepsychiatry Services
   Many psychiatry services are now provided via telehealth. Understanding the proper codes, place of service, and modifiers (e.g., 95 or GT) is essential for reimbursement.

3. Authorization Requirements
   Many insurance companies require prior authorization for psychiatric evaluations, follow-ups, or therapy sessions.

4. Frequent Changes in Coverage Policies
   Payers often change their behavioral health coverage policies, and failure to stay updated can result in claim denials.

5. Coordination with Therapists
   Psychiatrists often work in multidisciplinary practices. Coordinating billing across psychiatrists, psychologists, and therapists can complicate claim submissions.

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Progressive RCM’s Psychiatry Billing Services

Our specialized psychiatry billing services help mental health providers improve cash flow, reduce denials, and maintain full compliance.

✅ Accurate Coding & Documentation Support

We apply the correct CPT codes, ICD-10 diagnostic codes, and modifiers based on session type (e.g., new evaluation, follow-up, psychotherapy with or without medication management, telehealth, etc.).

Examples of common codes we bill:

• 90791 – Psychiatric diagnostic evaluation (no medical services)

• 90792 – Psychiatric diagnostic evaluation with medical services

• 90833, 90836, 90838 – Psychotherapy add-on codes (with E/M)

• 90834 – 45-minute psychotherapy session

• 90837 – 60-minute psychotherapy session

• 99494 – Collaborative care management (CoCM)

✅ Claims Submission & Tracking

We submit clean claims within 24–48 hours through electronic clearinghouses and track every claim’s status to ensure timely payments.

✅ AR Management & Denial Resolution

Our AR team follows up on aging claims, corrects rejected or denied submissions, and appeals where necessary — reducing outstanding balances.

✅ Prior Authorization Management

We handle pre-authorization requests, follow-ups, and documentation for new patient evaluations, long-term therapy sessions, and medication services.

✅ Telehealth Billing Support

We correctly apply POS codes, modifiers, and payer-specific telehealth guidelines for virtual visits.

✅ Patient Billing & Collections

Our team handles patient statements, payment plans, and support calls, ensuring transparency and respect for individuals in sensitive mental health situations.

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Common Psychiatry Services We Bill For

• Initial psychiatric diagnostic evaluations

• Medication management

• Individual psychotherapy (30, 45, 60 minutes)

• Family therapy (with or without patient)

• Group therapy

• Telepsychiatry

• Collaborative care management

• Psychological testing

• Crisis intervention services

Each service has its own billing rules and time thresholds. We ensure each is billed precisely to avoid revenue loss.

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Our Psychiatry Billing Workflow

1. Patient Insurance Verification
   We confirm eligibility, co-pays, deductibles, and prior authorization requirements before the appointment.

2. Charge Entry & Coding
   Accurate service coding based on session time, type, and documentation.

3. Claim Submission
   Electronic claims submission with payer-specific formatting and modifier requirements.

4. Payment Posting
   Accurate posting of insurance and patient payments, including reconciliation with payer contracts.

5. AR Follow-Up & Appeals
   Timely follow-up on unpaid claims, resubmission, and appeals to recover lost revenue.

6. Reporting & Insights
   Monthly reports on collection rates, claim status, denial trends, and therapist-level performance.

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Why Choose Progressive RCM for Psychiatry Billing?

✅ Behavioral Health Billing Expertise
Our coders are trained specifically in mental health and psychiatry billing, including proper documentation and time-based CPT coding.

✅ Comprehensive Authorization Handling
We obtain and manage insurance authorizations, so you don’t have to worry about denied sessions.

✅ HIPAA-Compliant and Confidential
We prioritize patient privacy and compliance with HIPAA and state regulations.

✅ EHR/EMR Integration
We work with popular behavioral health platforms like SimplePractice, TherapyNotes, Valant, and Kareo for seamless data flow.

✅ Fewer Denials, Faster Payments
Our denial prevention strategy reduces rework, shortens AR days, and increases your monthly revenue.

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Key Performance Indicators We Track

• Clean Claim Submission Rate

• First-Time Payment Rate

• Days in AR

• Denial Rate by Code

• Patient Collection Rate

• Session Utilization Rate

• Authorization Expiry Alerts

Our reporting helps you improve patient scheduling, therapy duration optimization, and financial forecasting.

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Benefits of Our Psychiatry Billing Services

1. Maximized Revenue – Capture every session and service you provide.

2. ⏳ Time Savings – Focus on care, not coding or chasing payments.

3. Mental Health Expertise – We understand the language and nuances of your specialty.

4. Fewer Denials – Prevent issues before they happen.

5. Better Financial Insight – Use real-time data to plan and grow your practice.

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Final Thoughts

Psychiatry practices deal with sensitive services and complex payer requirements. Without specialized billing, it’s easy to lose revenue, struggle with authorizations, or fall out of compliance.

At Progressive RCM, we handle all aspects of psychiatry billing with empathy, accuracy, and strategy — helping you serve your patients while we secure your payments.