Built on the realities of behavioral health payers.
We are not a generalist billing company that also takes therapy clients. Behavioral health is the only thing we do.
Why generalist billing fails behavioral health
The codes look simple from the outside. The payer behavior around them is anything but.
Authorizations that move
BH benefits change mid-cycle. Sessions reset. Carve-outs surface. We track every authorization and flag renewals 30 days out.
Modifiers that matter
Telehealth modifier policy still varies by payer. We maintain a per-payer rule set and apply the right combination on every claim.
Concurrent billing
ABA and group therapy require careful unit and provider attribution. We model it the way payers actually expect to see it.
Documentation alignment
When a denial is documentation-driven, we surface it back to the clinical team in plain language with a fix, not a complaint.
Codes we are built around.
From outpatient psychotherapy to ABA protocol work and IOP per diems, our workflows are designed around the behavioral health code set rather than retrofitted from a generalist playbook.
- Aligned with current CPT and HCPCS guidance
- Per-payer modifier and POS rule sets
- Add-on code logic considered as part of the scrub
- 90791Psychiatric diagnostic evaluation
- 90834Psychotherapy, 45 minutes
- 90837Psychotherapy, 60 minutes
- 90853Group psychotherapy
- 97153Adaptive behavior treatment by protocol
- 97155Adaptive behavior treatment with protocol modification
- H0015Substance abuse intensive outpatient
- 99214E/M, established patient
A free 30-minute audit of your behavioral health billing.
Send us a recent month of remits and we will tell you, specifically, where money is leaking and what we would change first.