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Mental Health Billing Services Near You

Looking for a mental health billing service near me? MedStates provides specialized billing support for mental health providers, ABA therapists and behavioral health providers nationwide-with a localized support across the U.S. For a therapist in Ohio (OH), a psychiatry clinic in Illinois (IL), or a counseling practice in Georgia (GA), our billing agents understand the coding and billing of behavioral health using EHR/EMR. From applying accurate CPT codes to insurance pre-authorizations and denial management, we got you covered with our mental health billing company. With our HIPAA-compliant, cloud-based system and familiarity with local payers in states like NY, NJ, PA, WA, CO and more, we deliver reliable billing solutions that feel local regardless of wherever you practice.

Why Choose Our Mental Health Billing Service Near You?

🧠 We Provide Billing Solutions— Not Just "Services"

Most billing companies treat mental health like an afterthought. MedStates don’t. Because we have built a team specifically for therapists and behavioral health providers. The mental health billing agents are responsible for:

  • Navigating insurance carve-outs and non-covered services
  • Using correct CPT codes for therapy sessions like 90791, 90834, and 90837
  • Applying modifiers like 95 and GT for telehealth billing
  • Handling both individual and group therapy claims
  • Managing Medicaid and state mental health program nuances

We don’t just “file claims.” We have learned the reaons for claim rejections and how to fix them.

🚫 No More Missed Revenue or Guesswork

Mental health billing is not just about submitting claim forms, it is about getting you paid accurately and on time. We eliminate:

  • Claims denied due to missing authorization or wrong POS code
  • Incorrectly calculated units under the 8-minute rule
  • Reimbursements delayed because of missing diagnosis linkage or documentation
  • Frustration from insurance reps giving you the runaround

We proactively track payer rules and our quality assurance department ensures complete documentation before claim submission.

👤 Built for Solo Providers, Group Practices & Telehealth

Whether you are a:

  • Solo private practice therapist
  • Group practice offering psychiatry + therapy
  • Virtual-only telehealth provider across multiple states
  • Clinic using a blend of Medicaid, Medicare, and private insurance

We provide customized billing solutions. We do not believe in one-size-fits-all. With MedStates, you will have a dedicated mental health billing specialist who understands your state rules, insurance mix, and service model.

📊 Full Visibility, Real Accountability

Unlike billing companies that hide behind vague reports or slow updates, we provide:

  • A real-time billing dashboard
  • Monthly reports with denial reasons and payer trends
  • Monthly summaries of net collection rates, aging claims, and precised billing performance

By choosing MedStates, you are never in the dark. No excuses. Just full control of your revenue.

🛠 Seamless Integration with Your Tools

We work with what you already use:

ICanNotes, SimplePractice. TheraNest. Availity, Waystar, TherapyNotes. Valant. OfficeAlly. Kareo. And more.

No new software to learn. No data migration headaches. Just a secure connection and go. Your clinical work stays where it belongs. We just turn your notes into revenue.

🔒 HIPAA-Compliant U.S.-Based Billing Solutions

We assure that the information shared with MedStates remains secure and protected at all times. The information received is only used for billing services. 

Need help? You get a dedicated accounts manager, not a call center.

🏁 Ready to Stop Chasing Claims?

You did not become a provider to deal with insurance companies. Let MedStates handle that.

Our Billing Services for mental health Near You

Billing for mental health is not plug-and-play. We offer hands-on, specialty-specific services that keep your revenue flowing whether you are billing Medicaid, Medicare, commercial plans, or EAPs.

Insurance Eligibility & Benefit Checks

Before your patient even walks in the door, we:

  • Verify behavioral health benefits, including session limits and authorization requirements
  • Identify co-pay, deductible, and OON coverage issues
  • Flag plans with mental health carve-outs or 3rd party administrators (like Optum, Magellan)

Avoid unpaid sessions due to overlooked eligibility issues.

Clean Claim Submission Within 48 Hours

We scrub, format, and submit claims for:

  • Individual therapy (CPT 90834, CPT 90837)
  • Group therapy (CPT 90853)
  • Intake and diagnostic (CPT 90791)
  • Add-on codes (e.g., CPT 90833, CPT 90785)
  • Teletherapy services (with correct modifiers and POS codes)

97% clean claim rate across major payers.

Payment Posting and Reconciliation

We do not just post EOBs. We:

  • Match payer payments to billed units
  • Track underpaid claims
  • Flag recoupments, offsets, or unusual adjustments
  • Provide detailed monthly reconciliation reports

Know exactly what you owe — and what you got paid.

Denial Management and Appeals

When payers stall, we fight back:

  • Resubmit corrected claims within 48 hrs
  • Draft clear, payer-specific appeal letters
  • Track root causes of denials and prevent repeat issues
  • Handle timely filing edge cases for out-of-network claims

We average a 30% recovery rate on previously denied claims.

Patient Statements and Collections (Optional)

Want us to handle your patient billing too? We:

  • Send clear, branded statements with plain language CPT explanations
  • Offer phone/email support for patient billing questions
  • Track unpaid balances and send gentle reminders (no aggressive tactics)

Reduce patient confusion and improve collections — while staying therapeutic.

EHR and Telehealth Billing Integration

We work inside your existing system (SimplePractice, TherapyNotes, Valant, etc.), or securely extract session and charting data for billing.

No double-entry. No switching platforms. Just efficient, secure workflows.

Real-Time Reporting

You will receive:

  • Weekly claim submission logs
  • Monthly A/R reports
  • Denial trend reports (by CPT, payer, modifier)
  • Aging reports grouped by session type or provider

Visibility = control over your revenue.

Add-Ons

  • Provider credentialing & CAQH management
  • Insurance panel applications and follow-ups
  • Clinical documentation audits before submission
  • Coding reviews for group practices and psych testing

MedStates provides comprehensive mental health billing services tailored for ABA therapy practices, psychologists, and behavioral health clinics. From insurance verification and clean claim submission to denial resolution, payment posting, and revenue reporting, our team ensures timely revenue cycle management. Whether you run a telehealth therapy practice, an in-person group counseling clinic, or a solo private practice, we have scalable solutions to support your growth.

In-House Billing vs. Mental Health Billing Agency Near You?

Feature / TaskIn-House BillingMedStates Mental Health Billing
Mental Health Billing ExpertiseGeneral medical billing knowledge; often lacks mental health focus100% specialized in mental health billing – therapists, psychologists, telehealth
Claim Submission SpeedOften delayed due to workload or staffing gapsClaims submitted within 24–48 hours, consistently
Claim Denial ManagementInconsistent follow-up; lacks formal appeals processProactive denial tracking, appeals drafted, denial trends analyzed
Revenue Loss RiskHigh: due to coding errors, missed rejections, eligibility oversightsLow: rigorous QA, pre-claim audits, payer-specific rule tracking
Staff BurdenBilling falls on admin or provider, leading to burnoutWe handle it all — you focus on care
TransparencyLimited or no reportingWeekly and monthly reports on A/R, denials, collections
EHR/EMR IntegrationManual workarounds, duplicate entrySeamless with systems like TherapyNotes, TheraNest, SimplePractice, Valant
Cost EfficiencySalaries, benefits, software, training, PTO costsPredictable, affordable billing fee with no overhead
Patient SupportStaff often uncomfortable explaining billingMedStates handles patient billing queries with clarity and empathy
Compliance & SecurityRisk of HIPAA violations due to lack of trainingFully HIPAA-compliant workflows with secure data handling
ScalabilityGrowth requires hiring and training new staffWe scale with your practice — solo or group, in one state or many

Billing Solutions Near You

Whether you are just launching a private practice or managing a multi-provider behavioral health clinic, MedStates offers billing solutions that flex with your needs. We specialize in supporting every level of mental health care delivery, from solo therapists to enterprise-level outpatient centers.

Solo Mental Health Providers

Are you operating an individual practice struggling to keep up with billing?

We work with:

  • Licensed Clinical Social Workers (LCSWs)
  • Licensed Professional Counselors (LPCs)
  • Marriage & Family Therapists (LMFTs)
  • Psychologists (PhD, PsyD)
  • Psychiatric Nurse Practitioners (PMHNPs)

Our services are ideal for solo providers who:

  • Accept both private insurance and cash-pay clients
  • Use EHRs like SimplePractice, TherapyNotes, or Kareo
  • Need help with eligibility checks, claim submission, and denial follow-up
  • Don’t have the time or resources to chase unpaid claims

✅ You get a dedicated billing expert without hiring in-house staff.

🧑‍⚕️

Group Practices

Running a group therapy or psychiatry clinic? We streamline your revenue cycle while you scale your care team. We serve:

  • Clinics with 2 to 50+ licensed mental health professionals
  • Multi-specialty practices offering therapy, testing, and medication management
  • Organizations with in-person, hybrid, or telehealth delivery models

We help you manage:

  • Multi-provider billing workflows
  • Complex payer mixes (Medicaid, Medicare, commercial, EAPs)
  • Modifier usage (e.g., GT, 95, HQ) for correct session coding
  • Group therapy CPT codes (e.g., 90853, 90849) and documentation

✅ We adapt our process to fit your size and practice model — not the other way around.

👥

Telehealth-Only Therapists and Virtual Clinics

Virtual providers face unique billing hurdles — different POS codes, state licensing laws, and payer telehealth policies.

We work with:

  • Fully remote therapy practices operating across multiple states
  • Digital mental health startups
  • Licensed providers offering virtual care via Zoom, Doxy.me, or EHR-native platforms

We ensure:

  • Proper modifier and location usage for reimbursement
  • Credentialing and payer enrollment support for virtual-only services
  • Compliance with state-specific telehealth billing rules

✅ You focus on care — we navigate the payer complexity.

💻

Multi-State Behavioral Health Providers

Expanding across state lines? We manage payer requirements, mental health carve-outs, and Medicaid plans in all 50 states.

We support:

  • Group practices operating in multiple states
  • Providers with compact licensure or telehealth expansion
  • Mental health clinics participating in Medicaid, Medi-Cal, MHSA, and more

We tailor:

  • Payer rules by region
  • CPT usage and documentation by state Medicaid rules
  • Provider credentialing across networks

✅ You stay compliant. We keep the cash flow moving.

🌍

Specialty Clinics and Niche Programs

We also support:

  • Eating disorder treatment centers
  • Substance use counseling (non-OTP)
  • IOP and PHP outpatient therapy programs
  • Clinics offering neuropsychological testing and assessments
  • EAP and out-of-network billing setups

 

🧑‍💻

At MedStates, we proudly serve therapists, psychologists, psychiatrists, counselors, behavioral health groups, and telehealth providers. Whether you are providing care from a private office, over Zoom, or across multiple states, our team brings unmatched expertise in mental health billing, payer navigation, and insurance reimbursement. From CPT code 90791 to complex Medicaid rules, we manage your revenue cycle with accuracy and efficiently.

Insurance Plans and Payers We Work With

We work with all major insurance carriers, state Medicaid programs, and specialized behavioral health organizations.

Commercial Insurance Companies

🏛️

We are in-network billing experts for mental health services across all major private insurance carriers:

  • Aetna Behavioral Health
  • UnitedHealthcare / Optum
  • Cigna (Evernorth)
  • Blue Cross Blue Shield (All state plans)
  • Humana
  • Tricare
  • Kaiser Permanente (when applicable)

We handle:

  • Authorization management
  • Coordination of benefits (COB) issues
  • Claims involving deductibles, copays, and coinsurance
  • Denial resolution and appeals

🧾 We stay on top of evolving behavioral health coverage policies, CPT changes, and reimbursement updates.

Medicare & Medicaid Billing

🩺

Billing mental health services to public payers requires deep expertise in compliance and documentation.

We process claims for:

  • Traditional Medicare (Part B)
  • Medicare Advantage plans (Humana, Aetna, UHC, etc.)
  • Medicaid in all 50 states
  • Medi-Cal (California)
  • Medicaid Managed Care Organizations (MCOs)
  • CHIP (Children’s Health Insurance Program)

Our team knows how to:

  • Use correct POS 02 / POS 10 codes for telehealth
  • Apply CPT and HCPCS codes for therapy, testing, and med management
  • Ensure compliance with local state billing requirements
  • Submit claims through portals like Availity, NaviNet, and state Medicaid systems

📍 We understand mental health billing for Texas Medicaid, Florida AHCA, New York OMH, Illinois HFS, and other state-specific programs.

EAPs, Out-of-Network, and Private Pay

💼

Mental health clinics often deal with diverse payer arrangements. MedStates is fluent in all of them.

We manage:

  • Employee Assistance Programs (EAPs)
  • Out-of-network (OON) claims and superbills
  • Single Case Agreements (SCAs)
  • Coordination with attorney liens, victim compensation, or grant-funded services

💡 Whether you are billing standard 90837 or handling an intensive outpatient claim, we optimize it for clean submission.

Our billing team has direct experience with behavioral health payer portals, EHR integrations, mental health carve-outs, and insurance verifications. Whether you’re billing Optum for 90834, Aetna for 90791, or navigating Medicaid plan nuances, MedStates ensures compliance and maximized reimbursement.

Find Mental Health Billing Services Near You Today

MedStates is your dedicated billing partner. We take care of the complex, ever-changing world of mental health billing so you can focus on what matters most: treating your patients.

✅ What Happens When You Reach Out?

  • Get a free billing audit within 24 hours
  • Receive custom pricing based on your volume and services
  • No long-term contracts — just transparent, reliable support
  • Direct access to a billing expert — not a call center

Let’s Improve Your Revenue, Compliance & Time Management

📬 Email: support@medstates.com
📞 Phone: +1-929-621-6059 
📅 Schedule a Call: Book a free consultation

📍 Serving All 50 States
🧠 Let MedStates help your mental health practice grow.

👉 Contact Us or Get Your Free Quote Now

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