Behavioral health billing
The billing considerations specific to behavioral health care — time-based psychotherapy, group and medication-management services, substance-use treatment, parity, carve-outs, documentation, and confidentiality.
20 articlesStart learning
On this page
What is behavioral health billing?
Behavioral health billing is the set of coding, documentation, and payer considerations specific to mental health and substance-use care. It carries features other specialties do not — time-based psychotherapy coding, group and medication-management services, parity protections, frequent benefit carve-outs, and the confidentiality rules of 42 CFR Part 2 — that shape how services are authorized, documented, and billed.
This section is an educational reference to how behavioral health is billed as a field. It covers the code families involved, time-based psychotherapy and evaluation-and-management services, group therapy and medication management, substance-use-disorder and medication-assisted treatment, behavioral health parity, prior authorization and carve-outs, documentation requirements, intensive outpatient and partial hospitalization, and how behavioral health is handled under Medicaid and Medicare.
It describes the field in the third person and does not represent that the site's operator provides or specializes in behavioral health billing. Coverage, coding rules, parity enforcement, and confidentiality requirements vary by payer, plan, state, and program and change over time, so the articles teach the durable structure and point to CMS, SAMHSA, Medicaid.gov, and the applicable payer for any current rule rather than quoting one that would go stale — and no copyrighted code descriptor is reproduced.
Where to start
A path from the shape of behavioral health billing to the denials specific to it. Each article assumes the one before it; the full set continues below.
See the overall shape
What makes behavioral health billing distinct — the service types, the payers, and the rules that other specialties do not carry.
Read: Behavioral health billing overviewUnderstand the code families
The categories of codes behavioral health uses — described at the concept level, without reproducing any code descriptor.
Read: Behavioral health code familiesBill time-based psychotherapy
How time drives psychotherapy coding, why documented time matters, and where time-based rules commonly cause errors.
Read: Psychotherapy time-based billingHandle evaluation and management
When evaluation-and-management services apply in behavioral health and how they interact with psychotherapy services.
Read: Evaluation and management in behavioral healthGet place of service and telehealth right
How setting and telehealth affect behavioral health billing, an area of frequent and changing payer rules.
Read: Behavioral health place of service and telehealthBill group therapy
How group services differ from individual ones in coding and documentation, and the distinctions payers look for.
Read: Billing for group therapy
Featured articles
Start here if you are new to behavioral health billing.
Behavioral health billing overview
An educational overview of how behavioral health billing works in the United States, covering the professionals and settings involved, the code sets and documentation that support claims, coverage structures such as parity and carve-outs, and where payer, plan, state, and program rules commonly vary.
Updated · 7 min readPsychotherapy time-based billing
An educational overview of how outpatient psychotherapy is billed by time, how session-length code families are structured, what documentation supports a time-based service, and how the specific rules vary by payer, plan, state, program, and date.
Updated · 6 min readAll articles
20 articles in this section.
Foundations3
Core services5
Substance use and intensive care3
Coverage, parity, and authorization4
Related topics
Where behavioral health billing connects to the wider revenue cycle.
Medicaid billing
The largest payer for behavioral health, where carve-outs and state variation are most pronounced.
Medicare billing
How behavioral health services are covered and billed under Medicare.
Prior authorization
A frequent requirement for behavioral health services, especially higher levels of care.
Related resources
Educational resources for behavioral health billing.
Key terms to understand
Plain-language definitions, defined once on their glossary pages.
About this section
What does the Behavioral Health Billing section cover?
The coding, documentation, and payer considerations specific to mental health and substance-use care: code families, time-based psychotherapy, evaluation-and-management services, group therapy, medication management, substance-use-disorder and medication-assisted treatment, parity, prior authorization and carve-outs, documentation, intensive outpatient and partial hospitalization, and how behavioral health is handled under Medicaid and Medicare. It is an educational reference and describes the field in the third person.
Does this section mean the site's operator provides behavioral health billing?
No. This section is educational reference material about how behavioral health is billed as a field. It does not represent that the site's operator provides, specializes in, or serves behavioral health billing, and nothing here should be read as a service claim.
Why doesn't this section list behavioral health codes, fees, or specific payer rules?
Because code descriptors are copyrighted and not reproduced here, and because fees, coverage, parity enforcement, and confidentiality requirements vary by payer, plan, state, and program and change over time. A code, fee, or rule printed here would be both an intellectual-property problem and quickly out of date. The articles describe the concepts and structure and point to CMS, SAMHSA, Medicaid.gov, and the applicable payer for the current, authoritative rule.
Authoritative sources
- Centers for Medicare & Medicaid Services (CMS) (opens in a new tab)
Publishes Medicare and Medicaid behavioral health coverage and billing guidance, including telehealth and collaborative care.
- Substance Abuse and Mental Health Services Administration (SAMHSA) (opens in a new tab)
The federal agency for behavioral health; publishes guidance on substance-use treatment and the 42 CFR Part 2 confidentiality rules.
- Medicaid.gov (CMS) (opens in a new tab)
The federal source for Medicaid behavioral health coverage, which varies by state.
Ready to improve your revenue cycle?
Explore our services and knowledge base to see how we can help.