Behavioral and Mental Health Billing and Coding Guide 2021

Behavioral health is the study of the feelings, biology, and intelligence that impact how a person behaves and how that gesture affects their diurnal life. Billing for behavioral and internal health services is complicated by the nature of the remedy handed to cases and the backing source for the treatment. Counselors and psychiatrists treat cases in a variety of ways, including remedy, drug, and contemplation. These treatment approaches bear varying ages of time depending on the case’s characteristics and the inflexibility of the disease. A case who’s impaired by their geste needs further employment training, knowledge instruction, and recuperation, among other effects. It’s critical to be apprehensive of the factors that contribute to delayed remittance and denials. Several typical reasons for denials include the following.



Prior Authorization. Utmost Behavioral/ Mental Health procedures bear that the provider gains previous authorization before the treatment.

  • Documentation Errors. CMS recommends specific attestation, including timesheets, encounter notes, time and place of service, and substantiation that a professionally led care platoon that included the case and their family developed the plan. It’s essential to establish the medical necessity of the procedures/ treatment, and detailed attestation can help you reduce denials.
  • Coding Accuracy. Time spent on remedy is an essential factor as billing for treatment is grounded on the number of units. Applicable medical codes grounded on the time spent can avoid crimes involving the number of units billed.
  • Policy Violations. CMS specifically identifies typical policy violations that do in billing for behavioral/ internal health treatments.

These include

  • Failure to record progress notes instantly
  • Billing for services that bear previous authorization without entering previous authorizations

To operate an economic practice/ billing business, it’s vital to bill directly and submit clean claims for the services rendered. Outsourcing your billing process relieves you of executive burdens and enables you to repurpose your pool. Also, it has the implicit to save a significant quantum of plutocrat due to billing and claim form problems. Our behavioral and internal health billers use assiduity stylish practices to maximize profit and minimize claim denials.

Medical Accounts Receivable Healthcare

CPT Code


Documentation Requirements

Psychiatric Diagnostic Procedures


Psychiatric diagnostic evaluation

– Assessment

– patient’s psychosocial history,

– current mental status, review, and ordering of diagnostic studies followed by appropriate treatment recommendations.


Psychiatric diagnostic evaluation with medical services




Psychotherapy, 30 minutes with a patient

Therapeutic communication to:

– Ameliorate patient’s mental and behavioral symptoms 

– Modify behavior  

– Support and encourage personality growth and development

Treatment for:  

– Behavior Disturbances  


Psychotherapy, 30 minutes with a patient with E/M

– Mental illness


Psychotherapy, 45 minutes with a patient

Helps a patient with a mental illness or behavioral disturbance identify and alleviate any emotional disruptions, maladaptive behavioral patterns, and contributing/exacerbating factors.


Psychotherapy, 45 minutes with a patient with E/M


Psychotherapy, 60 minutes with a patient

Helps a patient with a mental illness or behavioral disturbance identify and alleviate any emotional disruptions, maladaptive behavioral patterns, and contributing/exacerbating factors.


Psychotherapy, 60 minutes with a patient with E/M





Family psychotherapy (without the patient present), 50 minutes



Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes



Multiple-family group psychotherapy



Group psychotherapy (other than of a multiple-family group)


Psychotherapy for Crisis


Psychotherapy for crisis; first 60 minutes

Report these codes when the psychotherapy is for a patient with a life-threatening or highly complex psychiatric crisis.

*Billed for the first 60 mins of psychotherapy for a patient in crisis, and add-on code 90840 billed for each additional 30 mins.


Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service).


All psychotherapy CPT codes are time-grounded. The time for a psychotherapy law is defined as the time spent with the case and/ or case’s family.

Our technical behavioral and internal health billers and coders can deliver data-driven results to optimize your profit cycle.

Our staff is over to speed on HIPAA regulations governing behavioral and internal health billing and coding. We gain advance authorization from the case’s internal health insurance company to avoid denials in the long run. Our platoon of medical billers and coders are incontinently familiar with the ICD codes for behavior and mental health, enabling us to submit accurate claims.

Nixxe MBS enables you to more use your pool by fastening on executive conditioning. Our staff is devoted to optimizing the whole profit cycle process in order to exclude denials.