In behavioral health, per 2025 AAPC reports, pitfalls like missing start/stop times on 90837 sessions or incorrect GT/95 modifiers trigger denials and extend AR days. Tightened MHPAEA rules and CMS BHI expansions cost mid-sized clinics up to $20K yearly in lost revenue.
Payers demand detailed notes for anxiety sessions, prior auths for SUD IOPs, and time-stamped crisis interventions. Miss one detail, and AR balloons for 50+ days. From auditing 200+ clinics, 35% report burnout from chasing claims, while 20% undercode evals like 90791, leaving $10K+ on the table yearly. Furthermore, delays in mental health credentialing can stall your revenue for months. We manage the entire enrollment process to eliminate these initial financial gaps.
Documentation Shortfalls
60% of denials stem from vague notes on F43.x trauma disorders, as per AAPC audits
Targeted audits and templates tied to TherapyNotes or Valant EHRs
Payer-Specific Rules
Medicaid carve-outs delay SUD claims by 45 days on average
Automated prior auth tracking for Aetna and Tricare
Telehealth Glitches
25% rejection rate without proper GT modifiers
Real-time compliance scans before submission
Appeal Overload
15% of AR sits unworked, hitting smaller practices hardest
AI-flagged workflows that recover 80% of appeals
Coding Shifts
2025 E/M updates catch 30% of psych evals off-guard
Daily NCCI edit reviews by our experts
See how behavioral health practices have improved their operational and financial performance with our AI-powered billing services.
Documentation-Driven Denials
60% of rejections are tied to vague notes on F43.x trauma or F32.x depression, as per MGMA data. We deploy templates that link sessions to medical necessity proofs.
Prior Authorization Bottlenecks
30% of SUD claims stall under Medicaid carve-outs. Our services average 7-day approvals for Aetna Behavioral Health and Tricare evals.
Telehealth Modifier Mismatches
20% of virtual 90839 crisis claims bounce across MAC regions. We apply GT/GQ payer-by-payer, prepping for upcoming CMS in-person mandates.
AR from Unbilled Add-Ons
12% of 90846 family therapy goes uncaptured due to bundling errors. Our AR management recovers these in 30 days or less.
We cover the full spectrum of behavioral health billing services, from ICD-10 coding for depressive disorders to modifiers for tele-sessions. Ensuring your behavioral health billing is thorough and optimized, capturing every psychotherapy add-on and Substance Use Disorder (SUD) claim under the Mental Health Parity and Addiction Equity Act (MHPAEA).
Fragmented tools and outdated processes can slow reimbursements and disrupt your revenue cycle. Dastify’s behavioral health medical billing services and outsourcing solutions simplify your workflow and boost financial performance, much like our tailored setups for Addiction Treatment Centers and Psychiatry Groups.
We reduce denials for mental health claims through automated NCCI edits and root-cause analysis, targeting common hits like medical necessity on anxiety (60% of cases). Our workflows recover 85% on appeals, dropping rates to ≤4% which is a 75% improvement over industry averages.
