BEHAVIORAL & MENTAL HEALTH BILLING
Mental Health and Therapist Billing Services, Built for Behavioral Health Practices
Behavioral health billing that understands session-based coding, prior authorization tracking and CoCM. Built for psychiatrists, psychologists, therapists, group practices and ABA providers, including billing services for therapists in solo and small private practices.
- HIPAA Compliance Certified
- BAA signed with every client
- U.S. Wyoming LLC
- No setup fee
- No long-term contract
- Works inside your EHR
THE PROBLEM
Behavioral health gets billed like it's generic medicine. It isn't.
✕Prior authorizations expire mid-treatment and nobody catches it until the claim is denied
✕Session-based billing means high claim volume, so one error repeats across dozens of sessions
✕Medical necessity documentation requirements vary by payer and change without notice
✕ABA, SUD, group therapy, and individual psychiatry each need different coding, and generalist billers flatten them into one process
Sterling scrubs it before it's a denial.
Our AI is tuned to behavioral health's specific patterns, not a generic claims filter.
✓ Prior auth expiration tracked per session block, per patient
✓ CoCM and BHI add-on codes (G0568-G0570) applied correctly alongside APCM billing
✓ Telehealth POS and modifier rules checked against current CMS policy before submission
✓ Coders assigned by service type: ABA, SUD, group, and individual handled distinctly
2026 CODE CHANGES
What actually changed this year.
CMS finalized new Collaborative Care Model add-on codes in the CY 2026 Physician Fee Schedule.
📋
G0568: Initial CoCM Month
Add-on code based on CPT 99492, for patients also receiving Advanced Primary Care Management (APCM) services.
new for 2026🔄
G0569: Subsequent CoCM
Add-on code based on CPT 99493, billed alongside APCM base codes G0556-G0558.
new for 2026🧠
G0570: General BHI
Add-on code based on CPT 99484, for general behavioral health integration services delivered with APCM.
new for 2026📞
Telehealth Audio-Only
Audio-only is permanent for behavioral health under the Consolidated Appropriations Act, 2021. The December 31, 2027 date applies to the wider telehealth flexibilities, and the mental health in-person requirement is deferred to January 1, 2028.
policy noteHOW WE WORK YOUR CLAIMS
Built around the session, not a generic claim.
01
✅
Verify
Eligibility and remaining authorized sessions confirmed before the appointment.
02
🔍
Scrub
Time-based E/M, add-on psychotherapy codes, H-codes, and modifiers validated against payer rules.
03
⏱️
Track Auth
Prior authorization expiration tracked per session block so renewal happens before care is interrupted.
04
💰
Collect
Clean claims submit same-day; denials get root-cause analysis instead of generic resubmission.
CODE-LEVEL GUIDES
Behavioral Health Codes We Bill
Each code links to a guide covering documentation, modifiers, NCCI edits and the denial it draws most often, with the exact fix. Billing applied behavior analysis? Start with the ABA therapy billing guide. Billing therapy or psychiatry remotely? See the behavioral health telehealth billing guide.
| Evaluation, psychotherapy, testing, screening and collaborative care | ||
|---|---|---|
| Code | What it covers | Most common denial |
| CPT 90791 | Psychiatric diagnostic evaluation | Billed with psychotherapy on the same date |
| CPT 90792 | Psychiatric diagnostic evaluation with medical services | Billed with an office visit on the same date |
| CPT 90833 | Psychotherapy add-on, 16 to 37 minutes, with an E/M visit | E/M level chosen by time instead of medical decision making |
| CPT 90834 | Individual psychotherapy, 38 to 52 minutes | Session under 38 minutes billed as 90834 |
| CPT 90837 | Individual psychotherapy, 53 minutes or more | Time not documented, downcoded to 90834 |
| CPT 90853 | Group psychotherapy | More than one unit billed for one session |
| CPT 96130 | Psychological testing evaluation, first hour, with 96131 for each added hour | First-hour code repeated on a later day of the same evaluation |
| CPT 99492 | Collaborative care, first 70 minutes in the first month | Care manager time not evidenced |
| HCPCS G0444 | Annual depression screening | A second screening inside 12 months |
FAQ
What behavioral health practices ask first.
Do you offer billing services for therapists in private practice?
Yes. We provide therapist billing services for solo and group private practices, including licensed counselors, clinical social workers, marriage and family therapists and psychologists: eligibility and benefits checks, session coding, authorizations, claim submission and denial follow-up.
What are the new CoCM billing codes for 2026?
CMS finalized three new HCPCS add-on codes in the CY 2026 Physician Fee Schedule: G0568 (based on CPT 99492, initial month of Collaborative Care Model services), G0569 (based on CPT 99493, subsequent CoCM months), and G0570 (based on CPT 99484, general behavioral health integration). These bill as add-ons alongside APCM base codes G0556-G0558.
Is audio-only telehealth still billable for behavioral health in 2026?
Yes, and for behavioral health it does not expire. The Consolidated Appropriations Act, 2021 permanently removed the geographic and place of service restrictions for behavioral health telehealth, and two-way interactive audio-only technology is permitted, so the patient can be at home anywhere in the country. The December 31, 2027 date that gets quoted applies to the broader Medicare telehealth flexibilities rather than to behavioral health audio-only. Watch a separate deadline instead: the in-person visit requirement for mental health telehealth is deferred until January 1, 2028.
Why are behavioral health denial rates higher than other specialties?
Session-based coding, frequent prior auth renewals, and inconsistent payer documentation requirements drive it. Industry analyses put behavioral health denials around 16-20%, versus roughly 5-10% for general medical billing.
Do you bill ABA, SUD, and group therapy separately from psychiatry?
Yes. Each carries its own code set, modifiers, and payer logic, we do not run them through one generic process.
What EHR systems do you work with for behavioral health practices?
We work inside the EHR and practice management system you already use, no platform switch required for your staff.
How does Sterling reduce prior authorization denials?
Our AI flags claims likely to need prior auth before submission, tracks authorization expiration by session block, and confirms medical-necessity documentation is attached before the claim goes out.
Get the free Behavioral Health Denial Code Guide
Real codes, real citations, sent straight to your inbox, no spam.
Further reading on behavioral health billing
- 2026 behavioral health code changes. The 2026 code set updates that affect CoCM, psychotherapy and testing claims.
- Behavioral health prior authorization in 2026. What the AMA survey on prior auth delays means for behavioral health practices.
- Psychotherapy add-on coding. How the psychotherapy add-on codes pair with E/M and where the time rules bite.
- ABA therapy billing services. The 97151 to 97158 code set, unit ceilings, authorization rules and why ABA has no national rate.
Related reading
- Provider credentialing & payer enrollment. Before a behavioral health claim pays in network, the provider has to be enrolled and effective with that payer. We handle CAQH, Medicare PECOS, Medicaid and commercial panels.
- How we verify our coding guidance. The primary sources behind these pages, who reviews them, and how we correct errors.
- Full-service RCM. Eligibility, coding, claims, denials and AR follow-up, end to end.
- Prior authorization services. Requirement checks, submission, payer follow-up, appeals and renewals, handled for you.
- Denial management services. How to cut denials by reason code and appeal the rest before the deadline.
- Psychiatry billing services. Intake codes, E/M medication management and psychotherapy add-ons.
- Mental health claim denied?. What the denial codes mean for therapy claims and how to fix them.
- Credentialing services for therapists. NPI, CAQH, payer applications and Medicare for counselors and MFTs.
- Billing service for solo therapists. What a billing service should take off a solo therapist's plate.
- Credentialing checklist for new practices. Every document and step as a tick-box list, with a free printable PDF.
- Behavioral health billing by state. State Medicaid rules for New York, New Jersey, Illinois, North Carolina, Ohio, Texas and Florida.
- Payer credentialing for therapists. How to join Aetna, Cigna and Evernorth and Optum, plus Medicare for therapists.
- New York behavioral and mental health billing. eMedNY enrollment, Medicaid managed care networks and New York prompt pay.
- Florida behavioral health billing. Statewide Medicaid Managed Care plans that cover behavioral health, and Florida prompt pay rules.
- Free credentialing for new billing clients. Credentialing with 3 insurance payers at no cost when you start billing with us.
- SimplePractice billing services. A billing team that works inside your SimplePractice account.
- TherapyNotes billing services. A billing team that works inside your TherapyNotes account, without access to clinical notes.
- Headway vs Alma vs your own insurance billing. What each company says about credentialing, plans, fees and payment timing.
- Behavioral health billing in Texas. Texas Medicaid visit limits, therapist rates and telehealth rules.
- Behavioral health billing in Florida. Medicaid mental health benefits, therapist licensure and telehealth.
See it on your own behavioral health claims.
Eligibility verification (EV), benefits verification (BV), prior authorizations, and denial management at no cost for your first 30 days.
No setup fee. No long-term contract.