Behavioral health billing services from Medical Billing Services Group (MBSG) help therapy practices, psychiatrists, and treatment programs turn sessions into clean claims. We verify eligibility, code time-based sessions correctly, track telehealth rules, and work every denial — so providers get paid for the care they deliver.
Therapy claims getting denied? Get a Free Billing Audit — we will review a sample of your claims and show you exactly where revenue is slipping away.
Practice/setting fit
Our behavioral health billing services fit private therapy practices, multi-clinician group practices, psychiatrists, intensive outpatient and partial hospitalization programs, community mental health centers, and telehealth-only practices. The common thread is not the setting — it is the revenue risk that comes with time-based session coding, payer-specific telehealth rules, and session limits that change from plan to plan.
We handle the full revenue cycle for these settings: eligibility and benefits verification before the first session, prior authorization tracking, accurate coding of psychotherapy and psychiatric services, clean claim submission, payment posting, and systematic denial follow-up. Our dedicated medical coding support keeps session documentation aligned with what payers require, and our specialty billing programs are built around the rules that govern each discipline — not a one-size-fits-all workflow.
Documentation and coding risks
Behavioral health claims fail for different reasons than surgical claims. Sessions are time-based, telehealth rules change by payer and date of service, provider eligibility varies by discipline, and treatment documentation must show medical necessity visit after visit. These are the risk areas we watch most closely, each tied to a published source.
Telehealth sessions now carry in-person visit requirements
For Medicare patients, telehealth is no longer a paperwork-free option. CMS requires an in-person visit within the six months before the initial telehealth mental health treatment, plus a subsequent in-person visit at least every 12 months. Documented exceptions exist for patients whose circumstances make in-person care inappropriate and for groups with limited in-person availability — but the exception must be clearly justified in the medical record. Miss the in-person anchor or the exception documentation, and the telehealth sessions built on it are at risk. Commercial and Medicaid telehealth rules are separate and often stricter, so a workflow built only around Medicare leaves money exposed.
Payer/program: Medicare (CMS) · Jurisdiction: United States (federal) · Source: “Medicare & Mental Health Coverage” (MLN booklet MLN1986542) · Publication date: April 2025 · Effective date: October 1, 2025 (in-person visit requirements) · Last reviewed: 2026-10-07
Not every provider type can bill every payer
Medicare Part B recognizes a defined list of professionals who can bill for mental health services — physicians, clinical psychologists, clinical social workers, nurse practitioners, physician assistants, marriage and family therapists, and mental health counselors including certified alcohol and drug counselors — and each type must meet specific qualification and coverage requirements. The booklet’s April 2025 edition updated the requirements for marriage and family therapists and mental health counselors in particular. Claims submitted under a provider type the payer does not recognize, or by clinicians who are not enrolled and credentialed with that payer, are denied regardless of how good the session documentation is. This is why we verify enrollment and scope before the first claim goes out.
Payer/program: Medicare (CMS) · Jurisdiction: United States (federal) · Source: “Medicare & Mental Health Coverage” (MLN booklet MLN1986542) · Publication date: April 2025 · Effective date: per the April 2025 edition (no single effective date stated) · Last reviewed: 2026-10-07
Diagnosis codes expire — FY2027 applies from October 1, 2026
Every October, the diagnosis code set changes. CMS and the CDC’s National Center for Health Statistics publish the ICD-10-CM update, and for FY2027 the new codes apply to patient encounters from October 1, 2026 through September 30, 2027. Behavioral health claims are especially sensitive to this because they lean heavily on a small set of diagnosis codes — when one of those codes is revised, replaced, or retired, every recurring patient’s claim can start denying at once. We update code tables before the effective date and re-validate active treatment plans against the new set, so October turnover never becomes a November cash-flow problem.
Payer/program: CMS / CDC National Center for Health Statistics · Jurisdiction: United States (HIPAA-covered entities) · Source: “ICD-10 | CMS” (cms.gov/medicare/coding-billing/icd-10-codes) · Publication date: current page content as retrieved · Effective date: October 1, 2026 – September 30, 2027 · Last reviewed: 2026-10-07
Wondering what your denials are really costing you? Get a Free Billing Audit — we will trace a sample of denied claims back to the exact documentation or coding gap behind them.
Payer and authorization checks
Medicare’s mental health rules do not automatically apply to Medicaid or commercial plans — and assuming they do is one of the most expensive mistakes a behavioral health practice can make. Many commercial plans carve behavioral health out to a separate managed behavioral health organization with its own authorization portal, session limits, and medical necessity criteria. Medicaid rules vary by state plan and managed care contract. We verify benefits and authorization requirements before the first session, track session counts against plan limits, and re-verify when treatment plans extend. When an authorization is required, we submit the clinical documentation the payer asks for — not a generic packet — and we follow the request until there is a written determination. That upfront work keeps authorized sessions from becoming retroactive denials.
Workflow and reporting
Our workflow is built for how behavioral health practices actually run — high session volume, recurring appointments, and documentation that lives in an EHR built for clinicians, not billers. Each week we pull charges, scrub claims against payer-specific edits, submit clean claims daily, post payments, and work denials through our structured denial management process.
Reporting makes this visible. Illustrative examples of what our reports show: a weekly denial snapshot grouped by root cause (eligibility, authorization, coding, provider enrollment), an AR aging view that flags balances crossing 30/60/90 days, and a net collection rate trend by payer. These are illustrative examples, not guarantees — every practice’s numbers depend on its payer mix and documentation. But you will always know where your revenue stands and what we are doing about it.
Onboarding and pricing factors
Onboarding starts with the free billing audit — a real review of your recent claims, not a sales call. From there, implementation covers payer enrollment verification, EHR and clearinghouse connections, and a coding review of your most-used session types. Typical factors that shape a quote: monthly session and claim volume, number of rendering providers, payer mix (including carve-outs), telehealth share, and whether you need full revenue cycle or billing only.
We do not publish one-size-fits-all rates because they would be meaningless. Your proposal will specify the pricing model, minimum fees, and turnaround for implementation, along with the credentials of the team assigned to your account. We serve practices in all 50 states — call +1 (307) 396-4107 or email contact@medicalbillingservicesgroup.com to start the conversation, or see transparent pricing details.
FAQs and dated sources
Do you handle telehealth billing?
Yes. We bill telehealth sessions with the place-of-service and modifier rules each payer requires, and we track date-driven rule changes — including Medicare’s in-person visit requirements for telehealth mental health services in effect since October 1, 2025.
Can you credential our therapists with insurance payers?
We manage the enrollment and credentialing workflow — applications, CAQH, follow-up with payer reps — for the providers on your roster. Timelines vary by payer and state, so we set expectations up front and report status weekly.
What causes most behavioral health claim denials?
The patterns we see most: lapsed eligibility, missing prior authorizations, session length that does not match the coded service, and claims from providers not enrolled with the payer. Our independent billing audit identifies which of these is costing your practice the most.
Do Medicare billing rules apply to our commercial contracts?
No — not automatically. Commercial plans and Medicaid programs publish their own coverage rules, authorization requirements, and telehealth policies. We check the rules for each payer on your panel rather than assuming one set applies everywhere.
How do we start working with MBSG?
Start with a free billing audit — we review recent claims and show you the denial patterns and missed revenue. If the findings justify it, we scope onboarding around your volume, payer mix, and systems. Or contact our team directly.
Medical Billing Services Group — Medical Billing & Revenue Cycle Management. If behavioral health billing is costing you sessions, staff time, or sleep, start with a Free Billing Audit and see exactly where your revenue stands.
General educational information, not legal advice or a guarantee of reimbursement. Requirements vary by payer, plan, setting and date of service.
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