Behavioral Health and ABA Billing Services

Behavioral health billing is the process of getting paid for mental health, substance use disorder and ABA services. It covers eligibility checks, prior authorization, coding, claim submission, payment posting and denial follow-up. It differs from standard medical billing because many services are billed per diem or in timed units, authorizations control how much care is paid for, and the benefit may sit with a separate behavioral health plan instead of the member’s medical insurer.

Mental health billing for therapy and psychiatry practices centers on session-based CPT codes, evaluation and management visits and individual provider credentialing. Behavioral health organizations add program-level billing: per diem and revenue code claims for IOP, PHP and residential care, ASAM level-of-care documentation, 42 CFR Part 2 for SUD records and ABA timed-unit authorizations. If you run a therapy or psychiatry practice, see our mental health billing page. Therapists and counselors who give clients a superbill can use our free superbill template for therapy and counseling practices.

We bill the ABA family of CPT codes: 97151 and 97152 for assessment, 97153 and 97154 for technician-delivered treatment, 97155 for treatment with protocol modification, 97156 and 97157 for family guidance, and 97158 for group treatment, plus Category III codes 0362T and 0373T where a payer authorizes them. Each unit is 15 minutes, and we apply the HN, HO, HP or HM modifier your payer requires for the rendering credential.

ABA services need approval before billing, usually with a diagnostic report, treatment plan and standardized assessment results. We track each authorization’s start date, end date and approved units, and flag expiry well before units run out so the reauthorization request goes in on time. Before each claim is released, we compare billed units with what remains, which prevents unit-overage and expired-authorization denials.

Facility claims for intensive outpatient and partial hospitalization carry revenue codes: 0905 for psychiatric IOP, 0906 for chemical dependency IOP, and 0912 or 0913 for less or more intensive PHP. Many payers also want HCPCS codes such as H0015 for SUD intensive outpatient, S9480 for psychiatric intensive outpatient and H0035 for partial hospitalization. The right combination differs by payer and state Medicaid program, so we confirm it before the first claim.

Yes, for the billing work. Part 2 protects records that identify a patient as receiving substance use disorder treatment from a federally assisted program, and it restricts disclosure more than HIPAA does. We use SUD records only to bill and follow up on claims, under a written agreement with your program. Your program stays responsible for patient consent and Part 2 notices, and we do not disclose records beyond what the consent and the regulation allow.

Yes. We prepare and submit payer enrollment for BCBAs, licensed counselors, social workers and your organization, and we manage revalidations. Many payers do not enroll RBTs as individual billing providers, so their sessions are billed under the supervising BCBA according to each payer’s rules. Credential mismatches cause denials, so we match each rendering provider to the correct modifier and enrollment record before claims go out.

BilNow charges 2.7% of collections. There is no setup fee and no long-term contract, so the fee follows the money you collect rather than the number of claims or providers. Our HIPAA-trained staff work inside your existing practice management or EHR system, and we support more than 100 EHRs. Contact us for a review of your current billing before you decide.