Best Billing Practices for Therapy, Psychiatry & Behavioral Health

Mental health providers face a unique set of challenges when it comes to billing. Whether you’re a therapist managing your practice or a behavioral health clinic administrator overseeing multiple providers, the landscape in 2025 is anything but simple. The expansion of telehealth services, the implementation of more stringent payer regulations, the introduction of time-sensitive CPT codes, and the adoption of AI-generated documentation have all fundamentally transformed the reimbursement landscape for therapy and psychiatric services.

Despite these complexities, billing remains the foundation of a sustainable practice. Getting it right means fewer denials, faster payments, and more time focused on patient care. This comprehensive guide outlines the most effective current practices in behavioral health billing, providing practical strategies to enhance compliance, streamline administrative processes, and boost revenue. From CPT coding clarity to the role of AI in modern RCM workflows, here’s what every mental health professional needs to know this year.

Behavioral Health Billing Is Complex

Behavioral health billing is a different beast than billing for physical health services. It is primarily guided by session duration, personalized care plans, and detailed progress notes that must align accurately with specific CPT codes. Unlike procedural specialties that often use consistent treatment templates, therapy and psychiatric services are deeply personalized. This leads to a billing process that requires nuance, accuracy, and constant updates.

The most common CPT codes used in this field reflect session length and type. These include:

Codes	Description
90832	Psychotherapy, 30 minutes with the patient
90834	Psychotherapy, 45 minute
90837	Psychotherapy, 60 minutes
90791	Psychiatric diagnostic evaluation
90846 / 90847	Family psychotherapy, with or without the patient
90853	Group therapy

Each of these codes is tied to specific time thresholds and documentation requirements. In 2025, payers have increased scrutiny over longer sessions, particularly 90837, which is frequently used but now requires stronger justification. Session documentation must clearly demonstrate time spent, clinical need, goals addressed, and methods used.

The billing challenge intensifies with the rise of teletherapy. Remote services have brought convenience to patients, but they’ve also introduced modifier requirements, changing place-of-service codes, and payer-by-payer rules that practices must navigate daily. Keeping up with all of this while staying compliant is no small task, and often too much for a single provider to manage manually.

Billing Errors Are The Revenue Leaks

Even minor billing mistakes can result in denied claims, delayed payments, or compliance issues. In the mental health space, these errors often stem from mismatched CPT and ICD-10 codes, missing telehealth modifiers, and inadequate documentation.

Take time-based codes, for example. A common misstep is billing 90837 (60-minute psychotherapy) when the session documentation only supports 45 or 50 minutes. Payers now routinely audit long-session claims, especially when they’re billed consistently across multiple patients without documented variability. Practices also run into trouble when billing for services like family or group therapy without including the appropriate contextual notes.

Common Medical Billing and Coding Errors and How to Avoid Them

Telehealth introduces another layer of complexity. Payers require correct modifiers (usually 95 or GT), proper Place of Service codes (POS 02 or POS 10), and clear documentation of patient consent and session location. Missing just one of these details can lead to a rejected claim—even if the service was perfectly legitimate.

Fortunately, modern billing platforms are stepping in to bridge these gaps. At MaxRemind, AI-enhanced claim scrubbing helps identify mismatches between codes and documentation before a claim is submitted, significantly reducing the likelihood of denial. Our system also applies payer-specific logic to ensure modifiers and POS codes are correct for each insurance provider, removing the guesswork for your billing team.

Time-Based Billing Demands More Accuracy Than Ever

While therapy sessions are billed based on duration, the billed time must be accurately documented and supported by clinical justification. In 2025, payers are rigorously scrutinizing time-based CPT codes to verify that they accurately represent the actual clinical service time, rather than simply the elapsed clock time. The three most commonly used codes: 90832, 90834, and 90837—each correspond to specific time intervals.

90832 is appropriate for sessions lasting between 16 and 37 minutes
90834 covers 38 to 52 minutes
90837 should only be billed for sessions lasting 53 minutes or longer

The documentation must support both the time and the therapeutic content of the session. Simply stating “60-minute session” is no longer sufficient. Providers are expected to outline what was discussed, the interventions used, and how the session supported treatment goals.

Many clinics now utilize digital time-tracking solutions or employ AI tools that automatically extract session start and end times directly from the electronic health record (EHR), ensuring precise and efficient documentation. MaxRemind enhances this process by automatically analyzing session duration and suggesting the correct CPT code. If there’s a mismatch—such as a 47-minute session linked to a 90837 claim—the system flags it for review before submission, reducing errors and supporting compliance.

Teletherapy Is Here to Stay But Billing It Properly Is Non-Negotiable

Remote mental health services surged during the pandemic, and in 2025, they remain a core offering for many practices. However, billing for teletherapy still varies dramatically across payers, and mistakes can result in costly delays.

The first step is understanding which codes require which modifiers. Most payers use modifier 95 to indicate synchronous telehealth via audio-video, but others may still request GT. Additionally, the correct Place of Service code must be applied: POS 10 for services provided in the patient’s home, and POS 02 for telehealth services conducted outside the home.

Documentation must also reflect that the session occurred via telehealth, include patient consent for remote services, and note any relevant technical details (such as platform used or connection issues). These details matter to payers, and omitting them can result in claim rejection.

With MaxRemind, these variables are accounted for automatically. Our system cross-references payer rules in real-time to ensure each teletherapy claim includes the correct modifiers, POS codes, and supporting documentation. This drastically reduces the margin for human error and increases the likelihood of first-pass approvals.

AI Is Quietly Becoming the Backbone of Modern Billing

Artificial intelligence is not just a buzzword in healthcare—it’s solving real, daily challenges in medical billing. For mental health professionals, AI can help reduce denials, improve compliance, and minimize the time spent on administrative tasks.

By 2025, sophisticated billing systems like MaxRemind will harness AI to analyze therapist notes and automatically generate precise CPT code recommendations, based on session type, length, and documented interventions, thereby increasing billing accuracy and efficiency. This natural language processing (NLP) feature helps prevent both undercoding and overcoding, ensuring that all claims are supported by precise and reliable clinical documentation.

Artificial Intelligence: A Powerful Assist, Not a Replacement

AI further supports real-time claim scrubbing by identifying and flagging potential issues such as missing modifiers, non-compliance with payer rules, and discrepancies between diagnosis and procedure codes, all before the claim is submitted. More importantly, our denial prediction engine accurately identifies high-risk claims and highlights them for manual review, enabling teams to address potential issues proactively and reduce rejection rates before submission.

More importantly, our denial prediction engine accurately identifies high-risk claims and highlights them for manual review, enabling teams to address potential issues proactively and reduce rejection rates before submission.

Denial Prevention Starts With Process

Even with the best software, denials will still happen—but how often they happen is something your team can control. The key is establishing a proactive process that anticipates payer expectations.

Begin by identifying and monitoring your most frequent reasons for claim denials. Are they due to eligibility issues? Modifier errors? Lack of documentation? Identifying patterns helps you fix root causes. Providing thorough training to your front desk and billing team on pre-authorization processes and insurance verification procedures is essential, particularly for complex services such as psychiatric evaluations and medication management.

Best Practices for Denials Management in Healthcare

Internal audits are a must. Even reviewing a small sample of claims each week can help spot recurring errors. And when denials do happen, treat them as learning opportunities. Every explanation of benefits (EOB) from a payer offers clues to what went wrong.

At MaxRemind, we combine process with technology. Our platform flags potential denial triggers before submission and provides clear, actionable insights for correction. We also support appeal creation by leveraging data from the original claim to automatically pre-fill appeal letters, helping to accelerate the reimbursement process.

Managing Out-of-Pocket Clients Requires a Different Strategy

Not all behavioral health services are billed to insurance. Many clients choose to pay out of pocket for privacy, quicker access, or because their coverage is limited. Managing these payments efficiently is key to maintaining a healthy revenue stream.

Practices should consider offering sliding scale fees, prepaid session bundles, and transparent pricing posted clearly on their website. Online portals that allow for automatic payments or reminders also make the process easier for both client and provider.

MaxRemind supports private pay workflows in the same dashboard used for insurance billing. You can track session packages, apply discounts, and send automated payment reminders—ensuring that your revenue cycle remains smooth, no matter the payer type.

Is It Time to Outsource Your Behavioral Health Billing?

For many mental health providers, billing often represents the main obstacle to growth. If you find yourself dedicating more time to claims than to clinical care or feeling continually concerned about revenue, it may be time to seek additional support.

Outsourcing your billing to a partner like MaxRemind gives you access to a team that lives and breathes behavioral health compliance. We don’t just submit claims; we actively manage your revenue cycle, identify gaps in your documentation, and provide performance reports to help you scale.

With built-in AI tools and a dedicated team, you can finally take billing off your to-do list and refocus on patient care.

Explore MaxRemind Behavioural Health Medical Billing Services

Stay Compliant with MaxRemind

Reimbursement in behavioral health is always evolving. CPT code updates, telehealth policy changes, and payer rule shifts happen constantly—and practices that stay informed are the ones that stay paid.

Make sure your billing processes are up-to-date, your team receives ongoing training, and your technology partner keeps pace with industry shifts.

Book a Free Practice Audit

At MaxRemind, we stay ahead of the curve so you don’t have to. From coding updates to regulatory compliance, our team makes sure you have the tools and support needed to run your practice with confidence.

Get the Support You Need to Bill Smarter

In today’s mental healthcare environment, delivering quality care isn’t enough—you need a reliable, efficient billing strategy to keep your practice thriving.

Whether you’re looking to automate time-based coding, improve claim approval rates, or simply reduce the amount of time you spend on admin tasks, MaxRemind is ready to help. With AI-powered tools and deep experience in behavioral health billing, we make getting paid easier.

Ready to upgrade your behavioral health practice billing workflow?

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