Behavioral health billing, done by specialists
The full admissions-to-cash cycle for IOP, PHP, and residential care, where revenue is won or lost at verification, carve-out routing, and authorization, long before a claim goes out.
Revenue is lost before the claim, not after.
Behavioral billing runs on episodes, level of care, and authorization, not “visit, code, submit.” Miss one step upstream and delivered care becomes uncollectible.
- 01
The payer on the card isn’t the payer you bill
Behavioral benefits are carved out to Optum/UBH, Carelon, Evernorth, or Magellan. We verify the carve-out, not just the medical plan, so claims reach the right entity the first time.
- 02
Accuracy in documentation protects your codes
90832, 90834, and 90837 map to exact time bands. We audit time and medical necessity so your highest-value codes survive audit, with no default-to-90837 recoupment exposure.
- 03
Prior authorization is a revenue asset
Timely authorizations and renewals keep claims payable. We make sure deadlines are met, preventing denials and protecting your revenue.
- 04
Out-of-network & single-case agreements
We verify out-of-network benefits and track every step of the single-case agreement process to support timely approvals and reimbursement.
We bill by the time band, not the method.
There is no code for every therapeutic approach, only a code for documented time. We map each session to its duration, so the code matches the note and the claim survives review.
| CPT code | Time band | Description |
|---|---|---|
| 90832 | 16–37 min | Psychotherapy, patient and/or family member |
| 90834 | 38–52 min | Psychotherapy: the routine session standard |
| 90837 | 53+ min | Extended psychotherapy: documented time required |
| 90853 | Group | Group psychotherapy (other than family) |
| 99484 | Care coordination | General behavioral health integration, per month |
| 99492–99494 | Collaborative care | Psychiatric collaborative care management |
We speak every behavioral carve-out.
Each managed-behavioral org has its own auth rules, forms, and timelines. We maintain a live payer matrix so nothing slips.
- Optum / UBHProvider Express · concurrent review
- CarelonBehavioral Health · auth portal
- EvernorthCigna behavioral · SCA forms
- MagellanMedicaid & commercial carve-outs
See what your behavioral claims are leaving behind.
A no-obligation review of your denials, carve-out routing, and authorization workflow, with a recovery estimate.