Top 10 Mental Health Billing Companies in the USA (2026)

Mental Health Billing Companies in the USA: The Short Comparison

The Rules Behind Every Mental Health Claim

1. 1Coding and time

   Minutes set the code.

   Psychotherapy bills by face-to-face time using three main codes: 90832, 90834, and 90837. 90832 covers 16 to 37 minutes, 90834 covers 38 to 52 minutes, and 90837 covers 53 minutes or more. A note that says "60 minutes" without start and stop times invites a downcode or a denial. Every claim also needs ICD-10-CM diagnosis codes from the clinician's DSM-5 diagnosis, and the note has to support medical necessity.
2. 2Coding and time

   Evaluations follow their own codes.

   90791 is a psychiatric diagnostic evaluation without medical services, and 90792 includes them. Both are reported once per evaluation, not by the minute, and the interactive complexity add-on 90785 can sit beside them when communication factors, such as a caregiver or other third party, complicate the visit.
3. 3Coding and time

   Add-on codes sit beside E/M.

   When a prescriber adds psychotherapy to an evaluation and management visit, 90833, 90836, and 90838 use the same 16, 38, and 53 minute bands. Crisis psychotherapy uses 90839 and 90840, family sessions use 90846 and 90847, group therapy uses 90853, and psychological testing and brief screening use 96130 to 96139 and 96127, each with its own documentation rules.
4. 4Medicare

   Counselors and marriage and family therapists can bill Medicare directly.

   Medicare has paid licensed professional counselors and marriage and family therapists since January 1, 2024, which opened Medicare panels to many practices for the first time.
5. 5Medicare

   Telehealth from home is covered for mental health.

   Medicare lets patients receive mental health services by telehealth at home. The in-person visit requirement is on hold through 2027 and is scheduled to return in 2028 unless Congress acts again. Claims use place of service 10 for telehealth in the patient's home and 02 elsewhere, and many plans also expect a telehealth modifier such as 95 or 93 for audio-only.
6. 6Medicare

   Integration and digital codes follow their own rules.

   Psychiatric Collaborative Care bills under 99492 to 99494, general behavioral health integration under 99484 and G0323, and FDA-cleared digital mental health treatment devices under G0552 to G0554, each with time thresholds and a treatment plan on file.
7. 7Substance use treatment

   Part 2 raises the privacy bar.

   Substance use disorder records carry confidentiality rules beyond HIPAA. The compliance date for the 2024 update was February 16, 2026, and HHS now accepts Part 2 complaints.
8. 8Substance use treatment

   Authorization and level of care drive payment.

   Residential, partial, and intensive outpatient programs depend on utilization review, so a biller needs to track authorizations and clinical updates, not just claims. Levels of care follow the ASAM criteria, from outpatient and intensive outpatient to partial hospitalization and residential, and facility claims usually go on the UB-04 with revenue codes instead of the CMS-1500 that practices use.
9. 9Substance use treatment

   ABA runs on units.

   Applied behavior analysis bills adaptive behavior codes such as 97151 to 97158 in 15-minute units, so authorizations are counted in units and must be tracked as they are used.
10. 10Medicaid and commercial plans

    States set Medicaid rules.

    Many Medicaid programs bill behavioral services with H-codes or T-codes instead of CPT psychotherapy codes, each with its own authorization and filing limits. Certified Community Behavioral Health Clinics are paid under a prospective payment system in many states instead of per-code rates, which changes how encounters are reported.
11. 11Medicaid and commercial plans

    Parity law still applies.

    The Mental Health Parity and Addiction Equity Act requires plans to cover mental health and substance use care on terms comparable to medical care. Federal enforcement of the 2024 update's new provisions has been paused since May 2025, but the underlying law and earlier rules remain in force.
12. 12Medicaid and commercial plans

    Behavioral health panels differ.

    Many commercial plans carve behavioral health out to separate managed behavioral health organizations with their own credentialing panels, such as Optum, Carelon Behavioral Health, and Magellan.
13. 13Medicaid and commercial plans

    Credentialing comes before the first claim.

    A clinician cannot bill a payer until enrollment is complete, and a gap leaves sessions unpaid.
14. 14Medicaid and commercial plans

    Out-of-network and self-pay need their own paperwork.

    Out-of-network clients may need superbills or single case agreements, and the No Surprises Act requires a good faith estimate for self-pay and uninsured patients.
15. 15Medicaid and commercial plans

    Supervised billing varies by payer.

    Some plans let provisionally licensed therapists bill under a supervisor's credentials, and others do not, so check each plan and state.

Where Mental Health Claims Break

How to Test a Mental Health Billing Company

Signals to Walk Away From

• A percentage quoted on billed charges instead of net collections
• A promise to credential you with every payer in a fixed number of days
• Collection rate promises with no client data behind them
• Fees that surface after signing, particularly for credentialing
• No read-only access to your own claim and payer systems

Build In-House or Outsource?

Compliance Essentials Your Biller Should Already Know

What Does Mental Health Billing Cost?

Five Expensive Assumptions

1. 1

   "They said they do mental health."

   Doing mental health and specializing in it are different things. Ask any mental health billing company for its client count and the mix of practices and programs.
2. 2

   "Sessions are billed by the hour."

   Psychotherapy bills by documented minutes. A biller who rounds to the hour will lose claims on audit.
3. 3

   "We can credential later."

   A clinician who sees patients before enrollment completes may not be able to bill those sessions.
4. 4

   "Substance use billing is the same as therapy billing."

   Facilities depend on authorizations and Part 2 consent. Ask whether the team does both.
5. 5

   "We will skip the reference calls."

   Two conversations with practices or programs like yours tell you more than any proposal.

How We Ranked These Companies

Final Picks: Which One Fits You?

• TruCare if you want billing and credentialing on one record with a published rate.
• Nextus Billing Solutions if you run a treatment center and want utilization review and software included.
• Therapeutic Billing if you want credentialing started the day you sign.
• Sawgrass Behavioral Resources if you want a published 6% rate and a fast start.
• Integrity Billing if you want a free assessment and audit-style reporting for a facility.
• MHMI if you want a long-established biller and a live person on the phone.
• Prosperity Behavioral Health if you want analytics and payer contracting with your billing.
• Mental Health Insurance Billing Inc if your cases hinge on authorizations and appeals.
• United Billing Solutions if you suspect underpayments and want them recovered.
• Saints Billing Services if you are a solo therapist opening a private practice.

Frequently Asked Questions

TruCare Service Details