Mental Health Facility Billing: Overcoming Complexity with Expert Solutions

Billing for mental health facilities comes with unique challenges—varied service types, evolving payer rules, and the need for precise documentation. The stakes are high: errors can delay payments, cause compliance issues, and impact patient care.

At AMS Solutions, we specialize in medical billing for mental health providers, from outpatient counseling centers to inpatient psychiatric facilities. Our goal is to ensure providers get reimbursed quickly and fully while maintaining compliance with state and federal regulations.

Challenges in Mental Health Billing

• Complex CPT Codes: Psychotherapy codes (90832, 90834, 90837) vary by session length, while evaluation and management services require add-on codes.
  
• Insurance Verification: Not all insurance plans cover all types of therapy, and coverage limits vary widely.
  
• Telehealth Billing Rules: Since the pandemic, telehealth has become more common, but payers have different policies for virtual care.
  
• Frequent Denials: Errors in authorization, coding, or documentation are common in mental health claims.
  

Best Practices for Mental Health Billing

1. Verify Coverage Before Sessions: Confirm the number of covered visits, co-pays, and pre-authorization needs.
   
2. Document Thoroughly: Include start/stop times, session content, and therapeutic progress.
   
3. Stay Updated on Policy Changes: Mental health parity laws and payer telehealth policies evolve regularly.
   
4. Use Specialized Billing Staff: AMS Solutions’ team is trained specifically in behavioral health billing.
   

How AMS Solutions Supports Mental Health Facilities

• Comprehensive RCM Services: From eligibility checks to payment posting.
  
• Denial Management: Quick resolution of unpaid claims.
  
• Regulatory Compliance: We keep your billing practices in line with HIPAA, CMS, and state laws.
  
• Performance Reporting: Monthly insights into collections and denial trends.
  

Mental health billing requires attention to detail and specialized knowledge. Partnering with AMS Solutions means better collections, fewer denials, and more time to focus on patient care.