Mental health billing that keeps cash moving
Dastify BH handles mental health, psychiatry, and therapy billing. We help practices cut billing friction and recover unpaid revenue. AI-assisted workflows plus specialist review keep claims moving.
Dastify BH provides specialty medical billing for mental health, psychiatry, and therapy. Coverage runs from eligibility through denials and A/R. Specialty rules on prior auth, unit limits, carve-outs, and credentialing differ from general medical billing. Request a free revenue audit at /free-revenue-audit.
HIPAA-aware practices · Certified billing professionals · AI-supported workflows
Where Therapy Billing Quietly Loses Revenue
Therapy claims tend to look uniform. Most sessions use the same handful of CPT codes, and the volume of claims per week can hide small errors that repeat across dozens of visits.
The problems usually cluster around a few areas:
Session length billed does not match documentation
A 90837 (60-minute session) billed for a note that only supports a 45-minute session (90834) can trigger a payer audit or retroactive denial. Session length billing is one of the most audited areas of therapy billing.
Telehealth modifiers applied incorrectly
Payer telehealth rules have changed frequently since 2020 and continue to shift. Missing a modifier or applying the wrong one leads to denials that pile up before anyone notices the pattern.
Carve-out routing missed
Behavioral health benefits are often managed by carve-out payers like Optum, Carelon, or Magellan. Billing the medical plan instead of the carve-out results in automatic denials.
Credentialing gaps across group providers
Group practices adding new therapists often start billing before every provider is credentialed with every payer. Claims for uncredentialed providers process as out-of-network or deny entirely.
Family and group session codes billed incorrectly
90846, 90847, and 90853 have specific documentation requirements around who was present, whether the identified patient was in the session, and how the group was structured. Getting these wrong triggers denials or clawbacks.
The Therapy Codes We Work With
Therapy uses a compact set of CPT codes, but each one has documentation requirements and payer rules that shape how the claim gets processed.
Diagnostic evaluation
90791 for a psychiatric diagnostic evaluation without medical services. Used for initial intakes with therapists.
Individual psychotherapy
90832 for 30-minute sessions, 90834 for 45-minute sessions, and 90837 for 60-minute sessions. Documentation must support the time billed.
Family therapy
90846 for family psychotherapy without the patient present, and 90847 for family psychotherapy with the patient present. Documentation must confirm who was in the session.
Group therapy
90853 for group psychotherapy. Documentation must confirm the group structure and the identified patient’s participation.
Crisis psychotherapy
90839 for 60-minute crisis sessions, with 90840 as the add-on code for each additional 30 minutes. Requires documentation of crisis circumstances.
Add-on and interactive codes
90785 for interactive complexity when applicable, added to primary therapy codes.
Every one of these has payer-specific rules around session frequency, documentation, and coverage that affect whether the claim gets paid.
Solo Practice vs Group Practice Billing
Therapy billing looks different depending on practice structure.
Focus tends to be on individual credentialing with a manageable panel of payers, session-based billing, and often a mix of in-network and self-pay clients. Solo practices frequently deal with sliding scale considerations, superbill generation for out-of-network clients, and the administrative load of running billing while carrying a full clinical caseload.
Our billing approach adjusts to practice structure rather than applying the same workflow across every type of therapy practice.
Insurance Panels, Credentialing, and Therapy
Therapists face specific credentialing challenges that other specialties often do not deal with.
License type acceptance varies by payer and state
An LCSW accepted by one payer may not be accepted by another. LMFTs face different acceptance rules than LPCs or LMHCs. Psychology-level providers (PhD, PsyD) usually have broader acceptance but higher credentialing scrutiny.
Behavioral health carve-outs require separate credentialing
Being credentialed with Aetna or United medical does not mean being credentialed with Optum for behavioral health. This is one of the most common credentialing gaps in therapy billing.
Medicaid varies by state
Some states pay therapists directly through Medicaid. Others route behavioral health through separate MCOs with their own credentialing paths.
In-network vs out-of-network decisions
Some therapists operate entirely out-of-network and provide superbills to clients. Others are in-network with specific payers. Billing workflow depends on which model applies.
Getting credentialing right is part of what determines whether therapy claims get paid.
What Our Therapy Billing Service Covers
- Claim preparation and submission for individual, family, group, and telehealth therapy sessions
- Session length accuracy verified against documentation before billing
- Telehealth modifier and place of service coding
- Eligibility verification with attention to behavioral health carve-outs
- Credentialing support for individual and group providers
- Denial follow-up specific to therapy denial patterns
- Payment posting with underpayment identification against contracted rates
- Reporting by provider, payer, service type, and A/R aging
- Support for both in-network and out-of-network billing scenarios
See Where Your Therapy Billing Is Losing Revenue
Therapy claim errors often go unnoticed until denials build up or session length audits arrive months later. The free 90-day audit reviews recent therapy billing for coding accuracy, modifier compliance, credentialing gaps, and payer routing issues.
FAQ’s
Frequently Asked Questions
The most common therapy codes are 90791 for diagnostic evaluations, 90832 for 30-minute sessions, 90834 for 45-minute sessions, 90837 for 60-minute sessions, 90846 and 90847 for family therapy, and 90853 for group therapy. Crisis therapy uses 90839 and 90840.
