Resources
Medical billing and credentialing guides
Plain-English guides written by our billing and credentialing team. Rules vary by payer and state, so use these as a starting point and check current payer policy.
New to outsourced billing? Start with how to compare medical billing companies in the USA, then see our published pricing. Most practices lose money in three places: denied claims, aging A/R and slow credentialing. Our guides cover each one, and our denial management, A/R recovery and credentialing pages explain how we handle them for you.
Prescriber or therapist? Read the PMHNP credentialing guide or the CAQH ProView guide, and see psychiatry billing and billing for therapists. Want a second opinion on your own numbers? Request a free 90-day claims audit.
Free tools
Billing cost calculator
Compare in-house billing (salary, benefits, software) with an outsourced billing company, using your own numbers.
Open the calculator →Platform vs own contracts calculator
Compare earnings through Headway, Alma, Grow or Rula with your own insurance contracts plus a billing service.
Open the calculator →PMHNP requirements by state
Pick a state to see nurse practitioner practice authority, whether you need a collaborating physician, and the official board of nursing.
Open the tool →Therapist licensing by state
Pick a state to see LPC, LCSW and LMFT license titles, the official licensing boards and Counseling Compact status.
Open the tool →Mental health billing
Billing for a Telehealth Psychiatry Practice in Multiple States: Licenses, Payers and Claims
How to bill for a telehealth psychiatry or PMHNP practice with patients in many states: licenses, DEA, payer enrollment, Medicare, Medicaid and claim coding.
Read the guide →Telehealth Billing for Mental Health: POS 02 vs POS 10, and Modifier 95 vs GT
Which place of service and modifier to use for telehealth therapy and psychiatry visits, how audio-only visits are billed, and multi-state licensing.
Read the guide →Collaborative Care Billing (CoCM): 99492, 99493, 99494 and G2214 Explained
How the Collaborative Care Model is billed: who bills, the CoCM codes and time rules, team and consent requirements, and how psychiatrists and PMHNPs get paid.
Read the guide →Crisis Psychotherapy Billing: When to Use 90839 and 90840, Time Rules and Documentation
How to bill crisis psychotherapy with 90839 and 90840: what counts as a crisis, time thresholds, codes you can't bill the same day, and documentation.
Read the guide →Family and Couples Therapy Billing: 90846 vs 90847, and When Insurance Pays
When to bill 90846 or 90847, the time rules, why couples therapy is often denied, and how to document family sessions so insurance pays.
Read the guide →Group Therapy Billing (CPT 90853): Rules, Group Size, Documentation and Denials
How to bill group psychotherapy with 90853: one claim per member, group size and time rules, documentation, telehealth groups and common denials.
Read the guide →Incident-To Billing for PMHNPs: When It Applies, When It Doesn't, and the Risks
When a PMHNP's services can be billed incident-to a psychiatrist under Medicare, the supervision and new-problem rules, and when to bill under the NP's own NPI.
Read the guide →Interactive Complexity (CPT 90785): The Four Qualifying Factors and When You Can Add It
When the 90785 add-on code applies: the four qualifying factors, which codes it can be added to, which it can't, and what to document.
Read the guide →90791 vs 90792: Which Psychiatric Diagnostic Evaluation Code to Bill
The difference between 90791 and 90792, who can bill each, what the note must include, codes that cannot be billed the same day, and common intake denials.
Read the guide →90837 vs 90834 vs 90832: Which Psychotherapy Code to Bill
The time rules for 90832, 90834 and 90837, how to document session length, when to add 90785, and how to bill 60-minute sessions without triggering payer audits.
Read the guide →How to Bill 99214 With 90833: E/M Plus Psychotherapy for Psychiatry and PMHNP Visits
When a prescriber can bill an E/M code with a psychotherapy add-on (90833, 90836, 90838), how to pick each code, what to document, and why these claims get denied.
Read the guide →How to Bill Insurance as a Therapist: A Step-by-Step Guide
How therapists get paid by insurance: verify benefits, code the session, submit the claim, post payments and work denials before filing deadlines.
Read the guide →Intensive Outpatient Program (IOP) Billing: Codes, Authorizations and Common Denials
How mental health and substance use IOPs are billed: S9480, H0015, revenue codes 0905/0906, per diem vs per service, authorizations and attendance documentation.
Read the guide →Psychological Testing Billing Codes: 96130, 96131, 96136, 96137, 96138 and 96139 Explained
How to bill psychological and neuropsychological testing: evaluation vs administration codes, time units, technician codes, prior authorization and common denials.
Read the guide →Spravato (Esketamine) Billing: Codes, REMS, Prior Authorization and Buy-and-Bill
How psychiatry practices bill Spravato: REMS certification, prior authorization, buy-and-bill vs specialty pharmacy, Medicare G2082/G2083 and denials.
Read the guide →TMS Billing: CPT Codes 90867, 90868 and 90869, Prior Authorization and Coverage Criteria
How to bill transcranial magnetic stimulation: the three TMS CPT codes, typical payer coverage criteria, prior authorization, session tracking and common denials.
Read the guide →Credentialing
CAQH ProView: Complete Setup, Attestation, and Maintenance Guide
Step-by-step CAQH ProView help: set up your profile, turn on global authorization so payers can see it, upload documents and re-attest every 120 days.
Read the guide →How Much Does Insurance Credentialing Cost? Fees, Service Prices and How to Budget
What insurance credentialing costs in 2026: the fees you pay yourself, typical prices per payer, what raises the total, and how to budget for each provider.
Read the guide →PMHNP Credentialing: A Complete Guide for Psychiatric Mental Health Nurse Practitioners
PMHNP credentialing explained: behavioral health carve-outs, panel saturation, DEA and controlled substances, multi-state telehealth, and realistic payer timelines.
Read the guide →Georgia Medicaid Credentialing for Mental Health Providers: GAMMIS, the Centralized CVO and the Care Management Organizations
How therapists, psychiatrists and PMHNPs join Georgia Medicaid: GAMMIS enrollment, the centralized CVO, contracting with each CMO and the 2026–2027 plan changes.
Read the guide →How Long Does Credentialing Take? Timelines by Payer Type, and How to Avoid Delays
Typical credentialing timelines for Medicare, Medicaid, commercial plans and behavioral health networks, what slows applications down, and when to start.
Read the guide →Can LPCs and LMFTs Bill Medicare? How Counselors and MFTs Enroll
Since 2024, LPCs and LMFTs can enroll in Medicare. Who qualifies, how to enroll through PECOS, and how Medicare pays counselors and MFTs.
Read the guide →How to Get Paneled With Insurance as a Therapist: Steps, Timeline and Cost
How to get in-network with insurance as a therapist or counselor: what you need, how long it takes, what it costs, and what to do if a panel is closed.
Read the guide →Nurse Practitioner Credentialing: Complete 2026 Guide for FNPs, PMHNPs, and NPs
How nurse practitioner credentialing works in 2026: Medicare, Medicaid, and commercial enrollment, timelines by payer, state practice rules, and how to avoid delays.
Read the guide →Starting a private practice
How to Start a PMHNP Private Practice: A Step-by-Step Checklist for Psychiatric Nurse Practitioners
Start your own PMHNP practice: practice authority, business setup, DEA, EHR, credentialing, multi-state telehealth, billing and a realistic timeline.
Read the guide →How to Start a Private Practice as a Therapist: A Step-by-Step Checklist for LPCs, LCSWs and LMFTs
Start your own therapy practice: licensing, business setup, NPI, malpractice, EHR, insurance credentialing, Medicare, multi-state telehealth and billing.
Read the guide →How to Start a Psychiatry Private Practice: A Step-by-Step Checklist for Psychiatrists
Start your own psychiatry practice: licensing, DEA, business setup, EHR, credentialing, Medicare choices, multi-state telehealth, billing and a timeline.
Read the guide →Choosing a billing partner
How Much Do Medical Billing Companies Charge? Pricing Models, Hidden Fees and Real Monthly Costs
What medical billing companies charge: percentage, per-claim and flat-fee pricing, hidden fees to ask about, and real monthly costs for any specialty.
Read the guide →How to Choose a Mental Health Billing Company: Checklist, Questions to Ask and Red Flags
A practical checklist for psychiatry, PMHNP and therapy practices comparing billing companies: what to ask, how pricing works, and the red flags to avoid.
Read the guide →Medical Billing Companies in USA: Market Guide, Pricing, and How to Shortlist
How the US medical billing market works: company types, onshore vs offshore, real pricing ranges (4-10% of collections), and how to shortlist the right partner.
Read the guide →Medical Billing Services for Small Practices: Complete Guide to Maximizing Revenue
Explore medical billing services for small practices, from claim submission and payment posting to denial follow-up, with practical steps to improve revenue.
Read the guide →Payer guides
Aetna Behavioral Health: Credentialing and Billing for Therapists and Psychiatric Providers
How therapists, psychiatrists and PMHNPs join Aetna’s behavioral health network, which Aetna products are separate, and common Aetna denials.
Read the guide →Anthem and Blue Cross Blue Shield: Credentialing and Billing for Mental Health Providers
How Blue Cross Blue Shield plans work for mental health providers: credentialing with Anthem in Georgia, BlueCard claims and common denials.
Read the guide →Cigna and Evernorth Behavioral Health: Credentialing and Billing for Mental Health Providers
How therapists and psychiatric providers join Cigna’s Evernorth behavioral network, how Cigna EAP differs from regular benefits, and how to fix common Cigna denials.
Read the guide →Optum Behavioral Health (UnitedHealthcare): Credentialing and Billing for Mental Health Providers
How to join Optum’s behavioral health network for UnitedHealthcare members, why UHC medical credentialing is not enough, and Optum denials.
Read the guide →Denials & A/R
Claim Denial Codes Explained: What CO-16, CO-50, CO-197, PR-1 and Others Mean and How to Fix Them
What common denial codes mean (CO-16, CO-18, CO-50, CO-97, CO-197, PR-1 and more) and how to fix each, for mental health and medical practices.
Read the guide →How to Appeal a Denied Insurance Claim: A Step-by-Step Guide for Practices
When to correct, reconsider or appeal a denied claim, what a strong appeal letter includes, Medicare's five appeal levels and deadlines, and how to track appeals.
Read the guide →Timely Filing Limits for Medical and Mental Health Claims: How They Work and How to Never Miss One
How timely filing limits work for Medicare, Medicaid and commercial payers, the separate deadlines for appeals, and how to prove a claim was on time.
Read the guide →Accounts Receivable Management in Medical Billing: How to Reduce Days in A/R
Learn how accounts receivable management reduces days in A/R, recovers aged claims, and keeps your medical practice’s revenue cycle healthy.
Read the guide →Top 10 Reasons for Medical Claim Denials (And How to Fix Them Fast)
The 10 most common reasons for medical claim denials, what each one costs your practice, and the exact fix for each. Plus a denial-prevention checklist.
Read the guide →Billing basics
Charge Entry in Medical Billing: Complete 2026 Guide with Examples
What charge entry in medical billing is, the full 7-step process with real CPT and ICD examples, the 12 most common errors, and how to fix each one fast.
Read the guide →Professional vs Institutional Claims: CMS-1500 vs UB-04 Explained
Professional vs institutional claims explained: CMS-1500 vs UB-04, 837P vs 837I, revenue codes, DRG payment, and when one visit generates both claims.
Read the guide →