Written by Corey Blackburn, DPM, Founder
Prairie Specialty Billing supports mental health providers and counselors with time-based psychotherapy claims, telehealth coding, credentialing, and follow-up. The work is claim submission, checking claims before they go out, denial appeals, and patient billing calls from a U.S.-based team.
Behavioral Health Billing for Small Practices
Which psychotherapy codes are time-based?
90832, 90834, and 90837 are the common individual psychotherapy codes. CMS describes the time bands as 16 to 37 minutes for 90832, 38 to 52 minutes for 90834, and 53 minutes or more for 90837. The code follows the psychotherapy time in the note, not the length of the appointment slot. Sessions under 16 minutes are not reported with these codes. The note needs a start and stop time or a total time.
Which place of service and modifier should a telehealth visit use?
Place of service 02, place of service 10, modifier 95, and modifier GT are applied per payer. A visit in the patient’s home and a visit at another telehealth site are not the same place of service. One pair of codes for every plan creates denials. We use the payer’s current rule for that visit.
Do Nebraska counselors bill a separate behavioral health plan?
No. In 2026, Heritage Health includes behavioral health in the same three statewide plans: Molina Healthcare of Nebraska, Nebraska Total Care, and UnitedHealthcare Community Plan of Nebraska. A counselor still has to be enrolled and credentialed with the plan that covers that member. Missing one plan means that plan’s members cannot be billed.
Commercial credentialing
Many commercial payers read a CAQH profile and then run their own credentialing. A complete CAQH file is not the same thing as being loaded at the payer. Claims sent before the payer has finished credentialing deny for enrollment, not for the CPT code.
Recurring visits
Small practices bill the same patients on a repeating schedule. Authorizations expire. A patient can add or drop a second plan between visits. Substance use disorder claims follow extra confidentiality rules. The team uses the practice’s workflow for those records.