What types of mental health providers do you work with?

We work with outpatient individual and group practices — therapists, psychologists, psychiatrists, LCSWs, and mental health counselors billing professional claims in Florida. We do not currently support inpatient psychiatric facilities.

How do you handle prior authorization for behavioral health?

We manage the full prior auth lifecycle — initial authorization requests, concurrent reviews, and appeals for denied authorizations. Sessions are never billed without confirmed coverage.

Do you bill for telehealth?

Yes. We stay current on CMS and payer-specific telehealth billing rules, including place-of-service codes, modifier requirements, and Florida Medicaid telehealth policies.

Mental Health

Mental Health Billing.
Florida specialists.

Outpatient mental health billing requires mastery of prior authorization workflows, behavioral health CPT coding, and strict patient privacy protocols. We handle authorization management, complex behavioral health coding, and payer-specific compliance for outpatient practices and telehealth providers in Florida.

Request Free Audit →See Pricing

Auth

Full prior auth lifecycle managed

Telehealth

CMS + payer compliant billing

HIPAA

Enhanced PHI protection

Florida payers covered

MedicareFlorida Medicaid FFSSunshine HealthHumana MedicaidCommercial PayersFlorida Blue

"Outpatient behavioral health billing for Florida providers."

What we handle for mental health billing.

Prior authorization management — full lifecycle

Behavioral health CPT coding (90837, 90834, 90847, H codes)

Telehealth and telepsychiatry billing compliance

HIPAA-first workflows with enhanced PHI protection

Florida Medicaid behavioral health billing

Denial management for behavioral health payers

Outpatient individual, group, and family therapy

Medication management billing (99213, 99214, 90833)

PHP, IOP, outpatient — three different billing structures

Behavioral health billing has three structurally distinct claim types that get conflated by generalist billers. Outpatient sessions bill per encounter with E&M or psychotherapy CPTs (90791, 90832, 90834, 90837). Intensive Outpatient Programs (IOP) bill with H-codes (H0015) or revenue codes 0905-0907 depending on payer and place of service. Partial Hospitalization Programs (PHP) bill with H0035 or revenue code 0912 at a higher acuity rate. Confusing these — or mapping the wrong CPT to the wrong POS — generates payer-side denials at scale.

Place of service mapping is where Florida programs lose the most revenue. POS 11 for office is wrong for PHP — PHP should be POS 52 (psychiatric facility partial hospitalization) or in some cases 53 (community mental health center). POS errors don't always trigger immediate denials; sometimes the claim pays, but it pays at the wrong contracted rate. Our scrubbing engine enforces POS-by-payer rules so claims go out at the right rate.

Behavioral health carve-outs and prior-auth tracking

Most commercial behavioral health is carved out to a separate behavioral health vendor: Magellan, Beacon (now Carelon), Carisk, or the payer's own behavioral subsidiary. Routing claims to the medical payer when behavioral health is carved out generates a denial loop that wastes weeks. We maintain the carve-out routing matrix by payer and by employer group so the claim hits the right network on first submission.

Prior-authorization for PHP and IOP is essentially mandatory across all commercial payers and most Medicaid plans. Auths expire on calendar boundaries and on session-count thresholds — usually the smaller of the two. Sessions that occur after an auth expires deny in bulk, and re-authing retroactively only works on a narrow set of payers. Our auth tracking pushes an alert two sessions before the threshold so the next auth cycle starts before the cliff.