Mental Health Billing Blog: Essential Guides
This mental health billing blog explains claims, denials, credentialing, CPT codes and payer rules in plain English. It is written for psychotherapists, psychiatrists and the staff who bill for them. Browse the latest guides below, or filter by topic and state.
MCM South has billed exclusively for mental and behavioral health since 2010. This mental health billing blog comes from that daily work. We check payer and state rules against current sources, and we say so when a rule changes by state or by payer.
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Posts, page 23
What does your patient pay when they have a Co-payment
When a patient arrives at the (DOS) service date, the primary question for the patient’s insurance is whether they have a co-payment or…
Read more →What does a patient pay when they have a Deductible?
Taking the Mystery Out of Deductibles: Best Practices for Providers When a patient arrives at the (DOS) date of service, the primary…
Read more →What does your patient pay when they have co-insurance?
The Profitable Path: Maximizing Co-Insurance Collections for Providers When a patient arrives at the (DOS) date of service, the primary…
Read more →“Allowed” amount or rate when submitting claims to insurance
“Allowed” amount or rate is defined as the maximum amount insurance will pay for a covered service code. Based on the patient’s…
Read more →Coordination of Benefits (COB)
Coordination of benefits (COB) is a reason why claims are "Denied." Coordination of Benefits (COB) is when a patient has more than one…
Read more →Common reasons claims denied or rejected by insurance
There are various reasons why claims are denied or rejected by insurance. The best way to avoid claims being denied is to submit…
Read more →Topics
Billing Terms Glossary59CPT & Billing Code Guides59Telehealth & In-Home Rules22State & Regional Billing Guides72Claim Denials & Appeals6Payer Guides19Credentialing8Medicaid & Medicare6EAP Billing5Payer Policy Updates3Practice Management23Practice Software4What you will find on the mental health billing blog
The mental health billing blog falls into a few clear groups. Start with the one that matches the problem on your desk today.
- Payer guides. How a specific insurer handles mental health claims, for example Aetna billing.
- Claim denials and appeals. Why claims are rejected or denied, what to fix first, and how to appeal.
- Credentialing. How credentialing works, and how in-network and out-of-network status differ.
- CPT and billing codes. Psychotherapy and prescriber codes, modifiers and place of service, collected in the CPT & E/M code guide.
- State and regional guides. Billing notes for the ten states we serve: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.
- Medicaid and Medicare. Government payer rules. Medicare and Medicaid are run by the Centers for Medicare & Medicaid Services (CMS) together with state agencies. See our plain-English entry on Medicaid billing.
- Billing terms. Definitions for every term you will meet, in the Billing Terms Glossary.
You can also browse our Resources hub, see who we serve, or read about our billing services.
New to billing? Begin with the Billing Terms Glossary, then read the CPT guide. Already billing? Jump to the denial and payer guides to find out why a claim stalled and what to send next. Each post links to related guides, so you can follow a single question from the basic rule to the fix.
How to use the mental health billing blog
Rules differ by payer and by state. A commercial insurer, Medicare and a state Medicaid program can each treat the same claim differently, so every guide says which one it covers. Use the state filter to find your state, and the topic filter to narrow by problem. The mental health billing blog also has a search box for codes and payers.
Psychiatrists and other prescribers bill differently from therapists. They use evaluation and management (E/M) codes with psychotherapy add-on codes, so look for the posts on the mental health billing blog that say so.
Check the date on any post that names a rule, and confirm with the payer before you act. This mental health billing blog gives operational billing guidance. It is not legal advice. For real financial or legal exposure, talk with your attorney or compliance officer.
Mental health billing blog FAQs
The mental health billing blog is MCM South’s library of plain-English guides on claims, denials, credentialing, codes and payer rules for mental and behavioral health practices. New guides are added as we publish them.
It is written for psychotherapists and psychiatrists in solo and group practices, and for the office staff who handle billing.
Yes. Insurers, Medicaid programs and state laws differ, so each guide says which payer or state it covers. Use the state filter to find yours.
No. It is operational billing guidance. For legal or financial exposure, confirm with an attorney or compliance officer.
MCM South bills for psychotherapists and psychiatrists. You can request a free quote or schedule a consultation.
Use the state filter at the top of the blog, or the topic filter for state and regional guides. If your state is not listed, tell us what you need and we will point you to the closest guide.
Ready to hand off your billing?
MCM South handles insurance verification, electronic claims, denial follow-up, EAP billing and credentialing for psychotherapists and psychiatrists. Tell us about your practice and we will put together a custom quote.