Psychotherapy and E/M billing
Session codes, psychiatric evaluation and management codes, and the documentation that supports them must align with each payer's behavioral health benefit.
Psychology & Mental Health Revenue Cycle Management
Your Focus Is Mental Health. Ours Is Your Revenue.
Behavioral health reimbursement sits at the intersection of session-based billing, clinician credentialing, telehealth rules, and payer networks that treat mental health differently from medical care. Every layer can slow revenue when the workflow is not coordinated.
The Capri Collective supports psychologists, licensed counselors, therapists, psychiatrists, group practices, and outpatient behavioral health organizations with revenue cycle services tailored to how behavioral health is billed and paid.
Psychologists · Licensed counselors and therapists · Psychiatrists · Group mental health practices · Outpatient behavioral health organizations
Key reimbursement challenges
Where Revenue Gets Stuck in Psychology & Mental Health Revenue Cycle Management.
Group and family therapy sessions
Multiple-rendering-provider sessions, group therapy units, and family sessions carry distinct billing and documentation requirements.
Psychological and neuropsychological testing
Testing services involve unique codes, time-based documentation, and payer-specific coverage rules that require careful claim construction.
Telehealth billing requirements
Modifiers, originating-site rules, and payer-specific telehealth policies vary — and many were revised in recent years.
Credentialing and network participation
Clinician-by-clinician enrollment and participation status directly determines whether services are reimbursable at all.
Behavioral health carve-outs
When mental health benefits are administered by a separate payer or network, claims and follow-up must route correctly from the start.
Specialized services
What We Do for Psychology & Mental Health Organizations.
Behavioral Health Claims & Billing
- Psychotherapy, E/M, and testing claims
- Group, family, and individual session workflows
- Telehealth modifier and policy compliance
- Claims submission and rejection correction
- Payment posting and reconciliation
- Secondary billing coordination
Credentialing & Payer Participation
- Clinician enrollment and revalidation coordination
- Payer participation setup
- Behavioral health network and carve-out coordination
- Enrollment status tracking and billing troubleshooting
Denials, Appeals & A/R
- Denial investigation and appeals support
- Documentation and medical-necessity denials
- Aged receivables workdown
- Underpayment identification
- Payer escalation
- Recovery reporting
Revenue Visibility & Workflow Support
- Collections and denial reporting
- Payer-level performance visibility
- Supported practice-management revenue workflows
- Front-desk and billing education
- Intake-to-credentialing coordination
Comprehensive RCM connects claims, recovery, authorizations, credentialing and enrollment, patient and family collections, and reporting. We’ll define the functions and responsibilities around your practice’s needs.
Denial recovery & appeals
Denied Doesn't Have to Mean Lost.
Behavioral health denials frequently cite network participation, medical necessity, or telehealth rules. We investigate the underlying cause and coordinate the appropriate resolution.
Credentialing and network-status denials
Medical-necessity and documentation denials
Telehealth policy denials
Testing service denials and coverage questions
Appeals preparation and follow-up
Aged receivables and payer escalation
Underpayment identification
Root-cause analysis by payer and service line
You do not have to replace your existing billing department to engage Capri for targeted denial recovery. Routine recovery within the comprehensive agreement is covered by the contracted fee. Standalone projects and material expansions are custom-scoped and approved before additional charges apply.
Payer & operational considerations
Reimbursement Starts Long Before the Claim.
Payer Landscape
- Behavioral health benefit design and carve-outs
- Payer-specific telehealth policies
- Network participation and clinician enrollment status
- Testing service coverage rules
- Multi-payer documentation expectations
Operational Dependencies
- Clinician credentialing calendars
- Intake and benefits verification
- Scheduling aligned with session types
- Telehealth platform and documentation workflows
- Supported practice-management and EHR revenue workflows
Support is shaped by specific payer requirements, state rules, and available expertise. We do not imply universal payer expertise, guaranteed compliance, or clinical decision-making.
Capri Revenue360 connection
Every Step Accounted For.
This specialty sits within Capri Revenue360 — our connected operating philosophy that links eligibility & benefits, credentialing & payer setup, authorization management, claims, payments, denials, and reporting. Individual components and targeted projects are available without purchasing every service.
Your payer mix, claims volume, existing team, and growth plans shape the support we recommend.
Reporting & revenue visibility
Know Where Your Revenue Stands.
Reporting cadence, format, and indicators are defined by your engagement scope. Typical visibility includes:
Collection rates by clinician and payer
Denial rates and categories
Network and credentialing-related denials
Days in A/R and aging categories
Telehealth versus in-person reimbursement trends
Payer-level performance
Complimentary assessment
Where Is Your Revenue Getting Stuck?
Answer a few questions about your organization to receive a response-based Revenue Clarity Snapshot. It is a preliminary starting point for discussion — not a completed professional audit.
Your questions
Frequently Asked Questions
Do you handle credentialing for our clinicians?
Credentialing and enrollment coordination are available as part of a broader engagement or as a separately scoped project. We confirm payer and state specifics before assuming responsibility.
Can you help with telehealth billing questions?
We support claim construction, modifiers, and follow-up within each payer's telehealth policies. We do not provide legal advice on regulatory changes.
Our practice bills both therapy and medication management. Is that a fit?
Yes. We support mixed behavioral health practices and keep psychotherapy, E/M, and testing workflows distinct where payer rules require it.
What about parity-related reimbursement issues?
We can investigate underpayment and coverage patterns through normal payer follow-up and appeal channels. We do not provide legal representation or claim universal parity expertise.
Do you work with small solo and group practices?
Yes. Engagements are shaped around the size and complexity of the practice, from targeted A/R support to comprehensive revenue cycle management.
How do we get started?
Request the complimentary Revenue Clarity Assessment on our Revenue Cycle Management page, or contact us directly. We will review your situation and discuss fit.
Let's talk revenue
Your Revenue Deserves a Clearer Path Forward.
Whether you're navigating denials, aging receivables, payer requirements, or an entire revenue cycle that needs stronger oversight, we'd welcome the opportunity to understand your challenges.