Question 1

What billing codes do therapists use most?

Accepted Answer

Common therapy CPT codes include 90834 (45-min individual), 90837 (60-min individual), 90847 (family therapy), and 90853 (group therapy). Psychiatric codes include 90791 (diagnostic evaluation) and 99213-99215 (E/M with med management).

Question 2

What causes the most claim denials in mental health?

Accepted Answer

Common denial reasons: missing prior authorization, incorrect coding, eligibility issues, timely filing, and incomplete documentation. Many denials are preventable with proper verification and coding practices.

Question 3

Should I bill insurance or go private pay?

Accepted Answer

Both models have pros and cons. Insurance increases patient access but adds administrative burden and lower reimbursement. Private pay offers higher rates and less paperwork but limits patient access. Many practices use a hybrid model.

Question 4

What is a clearinghouse and do I need one?

Accepted Answer

A clearinghouse is an intermediary that submits claims to multiple payers electronically. Most practices benefit from using one (like Availity or Office Ally) as they reduce errors and speed up submissions.

Question 5

How can I reduce billing administrative time?

Accepted Answer

Automation helps: EHRs with integrated billing, eligibility verification tools, automated claim scrubbing, and electronic remittance. Some practices outsource billing entirely to specialized services.

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