Behavioral health billing is unusual in how much it depends on time. Many codes are defined by session length, which means the note has to record start and end times. Without them, a timed code has no support and the claim fails a records request.
Authorisation is the other pressure point. Most payers approve a set number of sessions, and once those run out, further visits are not billable regardless of clinical need. Tracking the count is as much a part of billing as the coding is.
What trips behavioral health claims up
- Session start and end times recorded, because timed codes fail without them
- Add-on codes attached to the right base code rather than billed alone
- Group, family and individual therapy separated cleanly per encounter
- Authorisation counts tracked so sessions don't run past what was approved
What we check before a claim goes out
- Session start and end times recorded at the encounter
- Add-on codes attached to a valid base code
- Authorised session counts tracked against visits delivered