Best Out-of-Network Therapy Billing Services for 2026

Handling out-of-network therapy billing can feel like a second job. You finish a session, then spend hours on claims, denials, and follow-ups. It’s exhausting. But it doesn’t have to be that way. The right billing service or software can take that weight off your shoulders. In this list, we walk through the top options for mental health providers , from full-service managed billing to integrated EHR tools. Whether you’re a solo practitioner or a growing group practice, you’ll find something here that fits. We’ll start with our top pick for hands-off billing.

1. MCM South , Best for Hands-Off Out-of-Network Billing

If you want to outsource your entire out-of-network billing process, MCM South is the clear choice. They specialize 100% in mental and behavioral health billing. That means they know the ins and outs of CPT codes like 90834, 90837, and 90847. They handle everything from patient insurance verification to claim submission and denial management. You focus on your clients; they handle the paperwork.

MCM South works with solo practitioners and group practices across the US. They verify patient benefits before each session, so you know exactly what to collect. They submit claims electronically through a clearinghouse and follow up until payment arrives. And if a claim gets denied? They handle the appeal. The result is consistent revenue without you lifting a finger.

One thing we love: they provide a dedicated billing specialist who knows your practice. No call centers. No endless hold times. They also offer credentialing support, which is huge if you’re moving in-network or expanding your payer mix. Plus, they work with all major insurers , Blue Cross, UnitedHealthcare, Aetna, Cigna, and more.

For out-of-network providers, MCM South makes it easy to collect the full fee from patients and then submit superbills or claims on their behalf. They also handle the tricky parts like understanding claims submission details and explaining deductibles to patients. It’s truly a hands-off solution.

2. TheraThink , Ideal for Solo Practitioners

TheraThink is a cloud-based practice management and billing platform built specifically for solo mental health practitioners. It combines scheduling, note-taking, and billing into one system. For out-of-network billing, TheraThink offers automated superbill generation and claim submission. You can set it up to send claims to insurance companies on behalf of your clients, or just provide a superbill. The system tracks payments and sends reminders.

One standout feature is the built-in insurance eligibility verification. Before a client’s first session, you can check their out-of-network benefits right from the dashboard. That helps you set expectations about deductibles and co-insurance. TheraThink also includes a patient portal where clients can view their superbills and pay online.

Pricing is affordable for solo providers , around $30-$50 per month depending on features. There are no long-term contracts. The interface is clean and intuitive, so you don’t need a billing degree to use it.

However, if you need more hands-on support for complex denials, TheraThink might fall short. It’s great for straightforward out-of-network billing, but if you’re dealing with many different payers or frequent denials, a dedicated billing service like MCM South might be better.

As noted in research, Medicare and Medicaid have specific rules for out-of-network claims, and TheraThink’s built-in logic can help you comply.

3. MediBillMD , High Clean Claim Rate for Therapists

MediBillMD is a medical billing company that specializes in mental health. They boast a 98% clean claim rate, which means fewer denials and faster payments. For out-of-network providers, they handle claim submission, patient billing, and denial management. They also offer credentialing services.

Their process starts with a free analysis of your current billing. Then they set up a customized workflow. You submit your session notes electronically, and they do the rest. They use advanced software to scrub claims for errors before submission, catching issues like missing modifiers (e.g., modifier 95 for telehealth) or incorrect place of service.

MediBillMD works with solo practices and small groups. They charge a percentage of collections , typically 5-7% for out-of-network billing. That can be cost-effective if you have high volume. But if you have few clients, a flat fee might be better.

One downside: you don’t get a dedicated biller; you work with a team. Some therapists prefer a single point of contact. Still, their high clean claim rate is hard to beat.

For more on how claims get processed, check out common reasons claims are denied and how to avoid them.

4. TherapyNotes Billing , Integrated EHR and Billing

TherapyNotes is a popular EHR for mental health professionals. Their integrated billing module supports both in-network and out-of-network claims. You can generate superbills with one click and submit claims electronically. The system automatically checks for errors and missing information.

For out-of-network, you can set up the client’s insurance as out-of-network, mark boxes 13 and 27 as “No” on the CMS-1500 form, and submit. The claim goes to the insurance company, but payment goes to the client. You collect your full fee at the time of service. TherapyNotes also tracks deductibles and co-insurance.

The software includes a patient portal where clients can view their superbills and insurance reimbursements. It also offers scheduling, note templates, and telehealth integration. Pricing starts at around $49 per month for solo providers.

The main drawback is that TherapyNotes is primarily an EHR; the billing is an add-on. If you need full revenue cycle management, you might still need a separate billing service. But for therapists who want to handle billing themselves with a reliable tool, TherapyNotes is strong.

Learn how insurance verification works to set up your claims correctly from the start.

5. SimplePractice , All-in-One Practice Management

SimplePractice is one of the most widely used practice management platforms for therapists. It offers scheduling, notes, telehealth, and billing all in one place. For out-of-network billing, you have two options: generate a superbill for the client to submit themselves, or submit the claim on their behalf. SimplePractice makes both easy.

To submit a claim as an out-of-network provider, you set the client’s insurance to out-of-network and select “No” for accept assignment. SimplePractice then generates a claim with boxes 13 and 27 marked accordingly. You can submit electronically or print and mail. The system tracks claim status and payments.

SimplePractice also includes a patient portal where clients can see their superbills and make payments. The software is intuitive and has excellent customer support. Pricing starts at $39 per month for solo providers.

The downside? If you want someone else to handle the entire billing process, SimplePractice won’t do that for you. It’s a tool, not a service. But for therapists who want control and a modern interface, it’s top-notch.

For a deeper look at the difference between billing software vs. billing service, our blog covers the trade-offs.

6. Kareo , Scalable Billing for Growing Practices

Kareo (now part of Tebra) offers a cloud-based practice management and billing platform designed for small to medium-sized practices. It’s especially good for growing mental health groups. Kareo handles out-of-network billing with features like automated claim creation, electronic claim submission, and denial management.

You can set up fee schedules for out-of-network rates and automatically generate superbills. Kareo also offers a patient portal where clients can view and pay their balances. The reporting dashboard shows key metrics like days in A/R and claim acceptance rates.

Kareo integrates with many clearinghouses and is used by over 80,000 providers. Pricing starts around $49 per month per provider. Their customer support is available via phone and chat.

One limitation: Kareo is not mental-health-specific. Some behavioral health workflows might require custom setup. But for general out-of-network billing, it’s solid.

See how MCM South’s services compare by offering dedicated support for mental health practices.

7. AdvancedMD , Strong Reporting and Analytics

AdvancedMD is a full-featured EHR and practice management system with strong billing capabilities. It’s designed for larger practices but can scale down. For out-of-network billing, AdvancedMD offers customizable fee schedules, superbill generation, and claim submission with real-time claim status.

Their reporting suite is one of the best in the industry. You can track reimbursement rates by payer, time to payment, and denial reasons. This helps you identify which out-of-network payers are most profitable. AdvancedMD also includes patient payment tools and an online portal.

Pricing is higher , typically $200-$400 per month per provider , but the strong features may justify the cost for practices with high volume. Implementation can be complex, so you’ll likely need training.

If you want outsourced billing instead of software, MCM South provides similar analytics without the learning curve. Learn about patient payment options for out-of-network services.

8. TheraNest , Affordable for Small Teams

TheraNest is a budget-friendly practice management software for therapists and small groups. It includes scheduling, notes, and billing. For out-of-network billing, you can generate superbills and submit claims electronically. The system also supports automatic payment posting and patient statements.

TheraNest’s pricing starts at $29 per month for solo providers, making it one of the most affordable options. They offer a free trial with no credit card required. The interface is clean but less customizable than some competitors.

One standout feature is the ability to set up recurring superbills for clients who need them monthly. The client portal allows patients to view and download superbills. TheraNest also offers a mobile app for on-the-go access.

However, if you need advanced denial management or dedicated billing support, TheraNest is limited. It’s best for therapists who want a simple, low-cost tool to manage their own billing.

For a full-service alternative, MCM South handles all that complexity. Check out tips for handling denied claims to improve your own process.

9. Practice Fusion , Free EHR with Billing Capabilities

Practice Fusion offers a free EHR that includes basic billing features. It’s used by many small practices. For out-of-network billing, you can create superbills and submit claims. However, the billing module is not as strong as paid solutions.

The free tier is attractive for therapists just starting out. You get e-prescribing, scheduling, and lab integrations. But the billing side may require manual work, like sending superbills via mail or fax. Practice Fusion also has ads within the platform.

For out-of-network claims, you can generate a CMS-1500 form and print it. The client then submits it to their insurance. There’s no direct electronic claim submission for out-of-network on the free plan. Premium plans offer more billing features but cost extra.

If you’re tight on budget, Practice Fusion can work, but expect to put in more time on billing. MCM South’s managed service might be a better long-term investment.

Understanding how deductibles affect patient payments is important for out-of-network billing.

10. athenahealth , Enterprise-Level Billing Solutions

athenahealth is a cloud-based EHR and practice management platform used by large healthcare organizations. They offer complete revenue cycle management, including out-of-network billing. Their system uses machine learning to optimize claim submissions and reduce denials.

For mental health practices, athenahealth provides specific tools for behavioral health, including CPT code libraries and authorization tracking. They also offer a patient engagement platform for online payments and superbill access.

Pricing is not publicly disclosed and is typically higher , suitable for mid-size to large practices. Implementation can take several months. But the analytics and automation are top-notch.

If you’re a solo practitioner or small group, the cost and complexity might be overkill. A specialized service like MCM South can give you similar revenue cycle management without the overhead.

The ACA requires mental health coverage, which affects out-of-network benefits. athenahealth helps handle these rules.

11. eClinicalWorks , Customizable Billing Workflows

eClinicalWorks is a well-known EHR with powerful billing customization. For out-of-network therapy billing, you can set up fee schedules, create superbills, and submit claims electronically. The system supports multiple clearinghouses and tracks claim status in real time.

One advantage is the ability to customize claim forms to include all necessary out-of-network details. eClinicalWorks also offers a patient portal where clients can view balances and make payments. Their reporting tools allow you to analyze out-of-network revenue streams.

Pricing varies based on practice size and modules. Implementation can be complex, but they provide training. It’s best for practices with dedicated billing staff.

If you prefer a simpler, hands-off approach, MCM South takes care of billing end-to-end. on mental health billing services to compare your options.

12. NextGen , Specialty-Specific Out-of-Network Features

NextGen Healthcare offers an EHR and practice management system tailored for ambulatory care, including behavioral health. Their out-of-network billing features include automated claim creation, eligibility verification, and denial management. They also offer a patient portal with superbill access.

NextGen’s strength is in handling complex billing rules for various payer types. They support both electronic and paing gives insight into reimbursement trends.

Pricing is enterprise-level, typically for larger practices or healthcare systems. Implementation is lengthy. Solo practitioners may find it too expensive and complex.

For most mental health providers, a simpler solution like MCM South or TheraThink is more usable. But if you’re part of a large group, NextGen is worth evaluating.

Check out common billing pitfalls for therapists to avoid revenue loss.

13. Greenway Health , Interoperability and Network Management

Greenway Health provides an integrated EHR and revenue cycle management platform for various specialties. Their Intergy EHR includes out-of-network billing capabilities, with tools for claim editing, electronic submission, and payment posting. They also offer a patient portal and online bill pay.

Greenway focuses on interoperability, so you can share data with other systems. For out-of-network providers, this means smoother claim processing with larger insurers. They also have a dedicated mental health template within the EHR.

Pricing is similar to other enterprise solutions. It’s best for medium to large practices. Customer support ratings are mixed.

If you value a single integrated platform, Greenway could work. But for out-of-network billing specifically, a specialized service may deliver faster results.

For a step-by-step look at how claims move from your practice to the payer, .

14. CareCloud , Revenue Cycle Management for Mental Health

CareCloud offers cloud-based practice management and revenue cycle management services. They support out-of-network billing for mental health providers with features like claim scrubbing, electronic submission, and denial tracking. Their patient payment platform allows for upfront collections and online payments.

CareCloud also provides analytics to track key metrics like days in A/R and collection percentage. They offer both software and full-service billing (at an additional cost). Their pricing is competitive for small groups.

One downside: they are not mental-health-specific, so some behavioral health nuances may be missed. But their technology is solid for general out-of-network billing.

For a truly specialized partner, MCM South remains the top pick. Learn about MCM South’s complete billing services.

How to Choose the Right Out-of-Network Billing Solution

Choosing between a full-service billing company and a billing software depends on your practice size, budget, and how much time you want to spend on admin. Here’s a quick checklist to guide your decision:

• Volume of claims: If you see 20+ clients per week, a managed service saves hours. For low volume, software may suffice.
• Technical comfort: Love tech? Try SimplePractice or TherapyNotes. Prefer to delegate? Go with MCM South.
• Denial rate: If you have a high denial rate, a service with denial management expertise (like MCM South) can recover lost revenue.
• Budget: Software costs $30-50/month. Full-service billing typically costs 5-10% of collections. Calculate which gives better ROI.
• Payer mix: If you deal with many different insurers, you need a service that understands each payer’s rules.

According to a study in Health Affairs, out-of-network spending has declined but still represents a significant portion of healthcare costs, making efficient billing critical.

Another key factor is the type of reimbursement: percentage-based (50-70% of UCR) vs. flat fee (EAP). Make sure your solution can handle both. For instance, managed services like MCM South can adapt to different reimbursement models.

For most therapists, the best choice is to start with a managed service like MCM South and then adjust as your practice grows. The time saved translates directly to more client hours and better revenue.

Frequently Asked Questions

What is out-of-network therapy billing?

Out-of-network therapy billing refers to the process of billing insurance when a therapist does not have a contract with the patient’s insurance company. The patient pays the full fee upfront and then submits a superbill or the therapist submits a claim on their behalf. The insurance company reimburses the patient based on their out-of-network benefits, which typically cover 50-70% of the usual and customary rate after the deductible is met.

How do I get reimbursed for out-of-network therapy?

The most common way is through a superbill. After the session, the therapist provides a detailed receipt with diagnosis codes, CPT codes (like 90837 for a 60-minute session), and proof of payment. The patient submits this to their insurance company, which then processes the claim and sends reimbursement directly to the patient. Some therapists also offer to submit the claim on the patient’s behalf using billing software.

What is the average reimbursement rate for out-of-network therapy?

Reimbursement rates vary by plan, but research shows they cluster between 50-70% of the usual, customary, and reasonable (UCR) rate. Some plans offer flat fees of $65-$100 per session, like Employee Assistance Programs (EAP). The actual amount depends on your specific plan’s out-of-network benefits, deductible, and co-insurance. It’s best to call your insurance to get an estimate.

Should I use a billing service or software for out-of-network claims?

It depends on your time and comfort level. Billing software like SimplePractice or TherapyNotes gives you control and costs less, but you still handle claims and follow-ups. A managed service like MCM South takes over everything, from verification to denial appeals, freeing you to focus on clients. If you see more than 15-20 clients per week, the service often pays for itself in reclaimed revenue.

What information do I need to submit an out-of-network claim?

For a successful out-of-network claim, you need the patient’s full name, date of birth, member ID, and insurance group number. The claim must include the provider’s name, NPI number, tax ID, service dates, CPT codes (e.g., 90834, 90837), diagnosis codes (ICD-10), place of service, and charges. Most EHRs generate this automatically. For telehealth, include modifier 95 and place of service 02.

How long does it take to get reimbursed for out-of-network therapy?

Turnaround time averages 30-60 days from claim submission. Insurance companies often process claims within 2-4 weeks, but delays happen if paperwork is incomplete. Using a billing service can speed things up because they have systems to track and follow up. Electronic submission is faster than paper. Some insurers now allow direct deposit for reimbursements.

Can I bill out-of-network for couples or family therapy?

Yes, but it’s trickier. Many insurance plans do not cover couples therapy. For family therapy, use CPT code 90847 (with patient present) or 90846 (without patient). Even if you’re out-of-network, the patient may get partial reimbursement. Verify benefits beforehand and explain that a diagnosis may be required for coverage. Some insurers cover family therapy only if it’s medically necessary for one identified patient.

What if my out-of-network claim is denied?

First, check the denial reason. Common issues include missing modifiers, incorrect diagnosis codes, or out-of-network deductibles not met. Correct and resubmit the claim. If you use a billing service, they handle this. You can also appeal the denial with additional documentation. According to CMS, many denials can be overturned with a simple phone call or corrected claim. CMS provides guidelines for Medicare-related denials.

Conclusion

Out-of-network therapy billing doesn’t have to be a headache. Whether you choose a full-service partner like MCM South or a software tool like SimplePractice, the key is to pick something that matches your practice size and how much admin work you want to handle. The research shows that reimbursement rates average 50-70% of UCR, and turnaround times run 30-60 days. With the right system, you can turn that into predictable cash flow.

If you’re tired of spending evenings on billing, consider handing it off. MCM South Medical Billing Service, LLC specializes in mental health billing and can take over your out-of-network claims from start to finish. You do the therapy , we speak insurance so you don’t need to. To learn more, visit MCM South or check out our YouTube channel for tips on billing and practice management. Your clients deserve your full attention, and your revenue deserves to be secure.