Behavior Therapy Billing is the heart of a practice’s business and often the most challenging aspect for mental health professionals. It involves navigating insurance policies, determining coverage eligibility, verifying client information, and applying the appropriate CPT (Current Procedural Terminology) codes for services rendered. Billing can be time-consuming and complicated, but it’s essential to getting paid.
Customized ABA Therapy Billing Services for Your Needs
In this article, we’ll explore the basics of Behavior Therapy Billing including terminology, insurance billing processes, and tips for managing your insurance billing efficiently. We’ll also dive into how to use behavioral therapy cpt codes, differences between in-network and out-of-network billing, the importance of credentialing, and why a therapist should consider outsourcing their insurance billing.
Addresses a Treatment Modality Gap
Prior to the creation of specific codes like 97154, there was no way for therapists to bill for group-based treatments. With this code in place, therapists can now confidently offer group sessions, allowing for more innovative treatment methods such as teaching students with social skills issues to interact with peers in real-time.
Time-Bound Billing
Unlike other behavioral healthcare billing codes, 97154 is time-based and requires that therapists document their activities in 15-minute increments. This allows therapists to accurately account for the amount of time spent in group sessions and ensures that they are paid for their work.
Many therapists assume that 97154 is reserved for long-term groups, but this is not the case. Despite having multiple therapists in the room, only one therapist can bill for a session using this code and it must be the lead therapist for the purposes of documentation and reimbursement.