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 →Mental health billing
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 →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 →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 →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, EAP vs regular benefits, and 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 →Credentialing
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 →CAQH ProView: Complete Setup, Attestation, and Maintenance Guide
How CAQH ProView works: profile setup, the 120-day re-attestation cycle, payer authorization, document uploads, and the errors that stall credentialing.
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 →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 →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 →Choosing a billing partner
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 →