Behavioral Health Billing & Revenue Cycle Optimization
Behavioral Health Billing & Revenue Cycle Optimization
Behavioral health billing presents a unique set of challenges that general healthcare revenue cycle expertise does not adequately address. The CPT code structure for psychiatric and psychotherapy services is distinct from medical billing. The H-code and T-code systems used for Medicaid SUD services require specialized knowledge. The billing rules for IOP and PHP programs — including the bundled service day billing structure — are frequently misunderstood and incorrectly applied. Telehealth billing has added new complexity with state-specific originating site requirements and parity law implications. And the authorization requirements for behavioral health services — particularly residential and inpatient levels of care — create administrative burdens that consume clinical resources and generate unnecessary denials when not managed with expertise.
We bring behavioral health billing expertise — not generic healthcare revenue cycle consulting — to every assessment we conduct.
Service Areas
Billing Code Optimization
Review of CPT, HCPCS, revenue, and Medicaid codes to identify missed revenue and coding inefficiencies.IOP & PHP Billing Compliance
Audits of day-rate billing, service bundles, schedules, and documentation to reduce risk and revenue loss.Documentation for Medical Necessity
Assessment of clinical documentation to strengthen claim approval and reduce denials.Managed Care Authorization Management
Workflow improvement for prior authorizations, concurrent reviews, and peer-to-peer processes.Denial Management & Appeals
Root cause analysis of denials with appeals systems, templates, and escalation strategies.Telehealth Billing Compliance
Review of telehealth billing practices for payer, state, and parity law compliance.Self-Pay & Sliding Fee Scale
Design of self-pay and sliding fee programs that balance access with financial sustainability.
Some or all of the services described herein may not be permissible for HealthBridge US clients and their affiliates or related entities.
The information provided is general in nature and is not intended to address the specific circumstances of any individual or entity. While we strive to offer accurate and timely information, we cannot guarantee that such information remains accurate after it is received or that it will continue to be accurate over time. Anyone seeking to act on such information should first seek professional advice tailored to their specific situation. HealthBridge US does not offer legal services.
HealthBridge US is not affiliated with any department of public health agencies in any state, nor with the Centers for Medicare & Medicaid Services (CMS). We offer healthcare consulting services exclusively and are an independent consulting firm not affiliated with any regulatory organizations, including but not limited to the Accrediting Organizations, the Centers for Medicare & Medicaid Services (CMS), and state departments. HealthBridge is an anti-fraud company in full compliance with all applicable federal and state regulations for CMS, as well as other relevant business and healthcare laws.
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Based in Los Angeles, California, operating in all 50 states.
