Behavioral health carries an administrative burden that is out of proportion to its reimbursement. Time based codes that have to match documented minutes exactly, prior authorization on ongoing treatment, and payers that manage behavioral benefits through separate carve outs with their own rules.

Practices in this specialty are frequently understaffed on the business side because the clinical work is the whole point. That is exactly where revenue leaks.

The 90832, 90834, and 90837 codes correspond to time ranges, and the note has to document actual time spent. Providers routinely round, estimate, or omit, and the resulting claim is not defensible.

Psychotherapy provided alongside an evaluation and management service uses add on codes with their own documentation requirements. Prescribers often bill one when both were performed.

Many behavioral benefits require reauthorization at intervals during ongoing treatment. Miss the window and sessions already delivered are not payable. This is a tracking problem more than a clinical one.

A patient’s medical benefits and behavioral benefits are often administered by different entities with different networks, different rules, and different claim addresses. Sending to the wrong one produces a denial that looks like a coverage problem and is not.

Collaborative care management codes and telehealth delivery both have specific documentation and place of service requirements that changed substantially in recent years and continue to shift.

• Charge entry and coding review against your documentation
• Claim submission and clearinghouse rejection management
• Denial classification by reason, source, and cause with actionable feedback to your team
• Accounts receivable follow up and payer escalation
• Payment posting and reconciliation
• Patient billing inquiries through our dedicated toll free line
• Monthly financial reporting so you can see what is actually happening

You keep your EHR and your workflow. We integrate with PrognoCIS, athenahealth, AdvancedMD, gGastro, Sevocity, eClinicalWorks, and Open Practice, among others.

We work with behavioral health practices as part of a broader commitment to independent providers who are carrying too much administrative load.

If your practice is spending clinical time on payer paperwork, that is the problem worth solving first.

Cyndi Walker founded Medicus after decades inside medical billing, and holds Certified Medical Coder and Certified Healthcare Business Consultant credentials. Medicus carries corporate accreditation from HBMA and the National Society of Certified Healthcare Business Consultants.

We are not a call center and we do not route your account offshore. You get people who know your specialty and answer the phone.

Yes. Time based psychotherapy codes correspond to defined ranges and the documentation has to reflect actual time. Rounding produces claims that will not survive review, and in a high volume practice it produces a lot of them.

Behavioral benefits are frequently carved out to a separate administrator with its own network and claim routing. Sending to the medical payer produces a denial that looks like non coverage and is actually a routing error.

Yes, using psychotherapy add on codes alongside the E and M, provided both services are documented distinctly. Many prescribers bill only one when they performed both.

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Schedule a billing review and we will tell you where the revenue is going.