A Billing Service Built for Therapists and Psychiatrists
MCM South is a billing service for therapists and psychiatrists that does one thing: mental and behavioral health billing for psychotherapists, psychiatrists, and the solo and group practices they run.
Get My Free ConsultationAt a glance
- Psychotherapists: timed therapy codes
- Psychiatrists: E/M visits plus therapy add-ons
- Solo practices: one clinician, one NPI
- Group practices: many clinicians, supervision rules
- Mental and behavioral health only. Not hospital systems.
Who is MCM South’s billing service for?
MCM South is a medical billing service for psychotherapists and psychiatrists who run solo or medium-size group practices. We work only in mental and behavioral health, and we do not serve hospital systems. We have served practices since 2010.
Therapists and psychiatrists both bill insurance for behavioral health, but they bill differently. The table shows the main differences. The codes are Medicare-defined. Commercial payers and state Medicaid programs add their own rules.
| Psychotherapists | Psychiatrists | |
|---|---|---|
| Diagnostic evaluation | 90791 (no medical services) | 90792 (with medical services) |
| Therapy visit | Timed psychotherapy: 90832, 90834, 90837 | Add-on to an E/M visit: +90833, +90836, +90838 |
| Medication management | Not part of the visit | E/M office visit: 99213, 99214, 99215 |
| How the code level is set | Minutes of face-to-face therapy | E/M level by medical decision making when billed with an add-on |
| Prescribing | Not applicable | Electronic prescribing of controlled substances (EPCS) applies |
Time ranges and documentation rules are in our non-E/M CPT code guide and the full CPT & E/M Code Guide.
Billing for psychotherapists
Therapist billing starts with who the clinician is. A psychotherapist, for billing purposes, is a licensed clinician who bills timed therapy sessions instead of medical office visits. That includes psychologists, clinical social workers, professional counselors, and marriage and family therapists. Which titles can bill, and for what, varies by state and by payer.
The codes that matter
- 90791: diagnostic evaluation, with no medical services. The usual first visit.
- 90832, 90834, 90837: individual psychotherapy, set by session length.
- 90846, 90847: family psychotherapy, without and with the patient.
- 90853: group psychotherapy.
- 90839 and +90840: crisis psychotherapy.
See time ranges and what the note must show in the non-E/M section of our code guide. Code-by-code guides: diagnostic evaluation, individual psychotherapy, family, group, and crisis.
Rules that depend on who pays
- Private payersEach payer sets its own credentialing, accepted license types, session-length rules, and prior-authorization rules. Verify with the payer before the first session.
- MedicareSince January 1, 2024, marriage and family therapists and mental health counselors can bill Medicare independently for diagnosing and treating mental illness, at 75% of the clinical psychologist rate. Enrollment is separate from commercial credentialing.
- State & MedicaidLicensure titles, telehealth rules, and Medicaid managed care rules differ by state. Never assume one state’s rule applies in another.
What MCM South handles for psychotherapists
We verify eligibility before the first session, build claims with the right code and time, follow up on denials, and handle credentialing and EAP claims where they apply.
Billing for psychiatrists
Psychiatry billing is built around the E/M (evaluation and management) office visit. A psychiatrist bills medication management with an E/M code, 99213, 99214 or 99215, and adds a psychotherapy add-on code, +90833, +90836 or +90838, when therapy happens in the same visit. An add-on is never billed alone.
Same-day rules to know (Medicare contractor guidance)
- The E/M service and the psychotherapy must be significant and separately identifiable.
- Document the time of each service, by minutes or start and stop times.
- Choose the E/M level by medical decision making. Time cannot be used to pick the E/M level when it is billed with psychotherapy.
Source: Noridian Medicare, Jurisdiction E Part B, updated 11/27/2024. Other Medicare contractors publish their own articles. See add-on codes and E/M and home-visit codes in our guide.
Prescriber note: EPCS
Medicare Part D requires Schedule II–V controlled substances to be prescribed electronically under the CMS EPCS Program. CMS measures each calendar year, sets a 70% compliance threshold, and grants automatic exceptions, including for prescribers who write 100 or fewer qualifying prescriptions a year. EPCS is a prescribing rule, not a billing code.
Rules that depend on who pays
- Private payersSome health plans send behavioral health to a separate carve-out company, so the right payer on the claim is not always the one on the card. Add-on and E/M pairing rules vary by payer. Verify before billing.
- MedicareThe add-on rules at left come from Medicare contractor guidance and apply to Medicare claims in that contractor’s jurisdiction.
- State & MedicaidMedicaid programs and state rules differ on which prescribers and services are covered. Check the state Medicaid site, or see our Medicaid HCPCS guide.
What MCM South handles for psychiatrists
We code E/M plus add-on claims to match what was done in the visit, verify eligibility and the correct behavioral health payer, follow up denials and appeals, and bill secondary claims.
Billing for solo practices
Solo practice billing, and the billing service for therapists that supports it, means one clinician, a psychotherapist or a psychiatrist, billing under their own National Provider Identifier (NPI). Every payer relationship, claim, and denial lands on that one person.
Monday morning for a solo practice
- Check eligibility for this week’s new patients before the first session.
- Confirm every note shows the date of service and the start and end time. See documentation requirements.
- List claims with no payment and no denial. Work the oldest first.
- Check where each payer credentialing application stands.
What MCM South handles for solo practices
Insurance verification, electronic claims, denial follow-up and appeals, secondary claims, and credentialing. You see the results. You do not chase payers.
Billing for group practices
Group practice billing involves two or more clinicians billing under a shared organization, usually with an organization NPI in addition to each clinician’s own. The billing questions that solo practices never face are who the rendering provider is and who supervises whom.
Supervised and associate clinicians
Incident-to is a Medicare rule. Under it, CMS requires general supervision by a physician or other listed practitioner for behavioral health services provided by auxiliary personnel incident to that practitioner’s professional services. The practitioner must have personally performed the initial service and remain actively involved in the treatment. Read the rule on the CMS incident-to page.
Commercial payers and state licensing boards set their own rules for billing a supervisee’s sessions under a supervisor. Payers differ on whose name and NPI go on the claim and whether a supervision modifier is required. Confirm each payer’s rule before an associate sees a patient.
Rules that depend on who pays
- Private payersCredentialing is per clinician, per payer. Supervision and associate-billing rules differ by payer.
- MedicareIncident-to rules at left. They do not automatically extend to commercial plans.
- State & MedicaidSupervision, licensure, and Medicaid enrollment rules vary by state.
What MCM South handles for group practices
We credential clinicians with each payer, verify eligibility, build claims with the right rendering and billing provider, and follow up denials. Our work is with solo and medium-size practices, not hospital systems.
What our billing service for therapists and psychiatrists handles for every practice type
Each service in our billing service for therapists and psychiatrists covers both psychotherapists and psychiatrists.
Insurance Verification & Eligibility Checks
Confirm coverage and the correct payer before the first session.
Electronic Claims Submission
Claims coded for behavioral health and scrubbed by a clearinghouse before they reach the payer.
EAP Billing
Employee Assistance Program claims, which start with authorization instead of a standard claim.
Denied & Rejected Claims Follow-Up and Appeals
Rejected claims fixed and resubmitted. Denied claims appealed.
Secondary Claims Billing
Claims sent to the second payer after the first one processes.
Insurance Credentialing
Getting and staying in network.
How we keep this page accurate
Sources: CMS incident-to page · CMS MFT/MHC page · CMS Medicare Mental Health booklet (MLN1986542) · CMS crisis psychotherapy page · Noridian Medicare JE billing tips · CMS EPCS Program. Unfamiliar term? See the billing terms glossary.
Questions practices ask us
Does MCM South bill for both psychotherapists and psychiatrists?
Yes. MCM South works only in mental and behavioral health, for psychotherapists and psychiatrists in solo and medium-size practices. We do not serve hospital systems. The codes differ between the two, so we code each claim to match who delivered the service.
How is billing different for a psychiatrist than for a psychotherapist?
A psychotherapist bills timed therapy codes, such as 90834 and 90837. A psychiatrist bills medication management as an E/M office visit (99213–99215) and adds a psychotherapy add-on (90833, 90836 or 90838) when therapy happens in the same visit. Under Medicare contractor guidance the two services must be separately identifiable, and the E/M level is chosen by medical decision making, not time.
Can an associate or supervisee bill under a supervisor?
It depends on the payer and the state. Medicare’s incident-to rule requires general supervision for behavioral health services provided by auxiliary personnel, and the supervising practitioner must have personally performed the initial service and stay actively involved. Commercial payers and state boards set their own rules, including whose NPI goes on the claim. Confirm with each payer first.
Can marriage and family therapists and mental health counselors bill Medicare?
Yes, since January 1, 2024. CMS lets them bill Medicare independently for diagnosing and treating mental illness, at 75% of the clinical psychologist rate. They need an NPI, a PECOS or CMS-855 enrollment, and coordination with their Medicare Administrative Contractor. Medicare enrollment does not credential them with commercial payers or Medicaid.
What does a solo practice need in place before billing insurance?
An NPI, an active credentialing status with each payer, eligibility confirmed before the first session, and notes that show the date of service and the start and end time. The payer’s own rules decide the rest, so verify them before the first claim.
Not sure which one describes your practice?
Get a free, no-pressure consultation about a billing service for therapists and psychiatrists from a specialist who only works mental and behavioral health billing.
Get My Free Consultation