Behavioral Health Medical Billing
& Credentialing Services
Behavioral health billing is unique—and often overwhelming. Unlike traditional medical specialties, it involves time-based CPT codes, complex documentation requirements, varying payer rules on session limits, telehealth compliance, and strict prior authorization policies.
At Oakview Medical Billing Solutions, we specialize in end-to-end revenue cycle management for psychologists, psychiatrists, therapists, counselors, and behavioral health groups. Whether you're billing 90837 or 90791, we ensure your claims get paid correctly and quickly—with zero errors or compliance risks.
Key Behavioral Health Billing Challenges
Behavioral health billing requires deep familiarity with:
Time-based Psychotherapy Codes: Codes like 90834 (45-min session) and 90837 (60-min) must exactly match documentation.
Evaluation & Management (E/M) + Psychotherapy: For psychiatrists, dual coding with modifiers (e.g., 99214 + 90833 + Modifier 25) is common.
Session Limits & Visit Caps: Most payers cap therapy visits per year unless pre-approved.
Pre-Authorization & Medical Necessity: Especially for intensive outpatient programs (IOP), PHPs, ABA therapy, and medication management.
Place of Service Sensitivity: Billing differs for in-office, home visits, telehealth, and facilities.
Telehealth Modifiers: Modifier 95 and GT, along with Place of Service 02 or 10, depending on payer.
CPT Codes for Behavioral Health
Behavioral Health Credentialing Services
We credential and contract behavioral health providers with government, commercial, and EAP plans. This includes:
Licensed Clinical Social Workers (LCSWs)
Licensed Professional Counselors (LPCs)
Marriage & Family Therapists (LMFTs)
Psychologists (PhD, PsyD)
Psychiatrists (MD, DO)
Board Certified Behavior Analysts (BCBAs)
Nurse Practitioners in psychiatry (PMHNP)
Group practices and mental health agencies
Credentialing Includes:
CAQH profile creation/updates
NPI registration
State license & DEA verification
Payer enrollment (Medicare, Medicaid, BCBS, Aetna, etc.)
EAP network credentialing
Paneling for telehealth platforms
We Work With:
Solo providers (private practice)
Telehealth-only therapists
Group practices & community mental health centers
ABA therapy providers & RBT networks
IOP / PHP programs
Dual diagnosis addiction treatment facilities
We Work With:
Solo providers (private practice)
Telehealth-only therapists
Group practices & community mental health centers
ABA therapy providers & RBT networks
IOP / PHP programs
Dual diagnosis addiction treatment facilities
Behavioral Health Billing Nuances
Oakview handles the tricky stuff:
✔ Psych testing documentation (time vs units)
✔ Concurrent therapy sessions (group + individual)
✔ Modifier 59 / 25 usage for bundled services
✔ ABA-specific billing per payer guidelines
✔ Ensuring compliance with psychotherapy session thresholds
✔ H0015/H0035/H2036 billing for IOP/PHP/Residential
Oakview's Behavioral Health RCM Highlights
Certified coders with CPC & mental health specialization
Real-time eligibility & pre-auth support
Denial prevention and appeal writing
Custom claim templates & SOAP note auditing
Insurance verifications within 24 hours
Monthly performance reporting
Why Behavioral Health Providers Choose Oakview
No volume minimums
HIPAA-compliant systems
Manage follow-ups, appeals, re-submissions
Transparent pricing — no hidden fees
Access to a dedicated account manager
Contact
Subscribe to our newsletter
271 W. Short Street, Suite 410 Lexington,
KY 40507
© 2025 Oakview Medical Billing Solutions | All rights reserved | Privacy Policy