behavioral health RCM Archives - Page 22 of 30

How long does behavioral health credentialing actually take in 2026? We break down commercial vs Medicare timelines, revenue impact, and what to do while you wait.

Telehealth Modifier 93 vs 95: What BH Practices Get Wrong

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| Behavioral Health

Modifier 93 vs 95 for behavioral health telehealth billing in 2026: learn which modifier to use, when payers deny, and how to recover lost revenue fast.

Why 40% of Mental Health Practices Get Stuck in Credentialing Purgatory in 2026 (And the Specific Fixes to Get In-Network in 90 Days Not 180)

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| Behavioral Health

Two industry stats every BH practice owner should know: 40% of mental health professionals report significant credentialing delays or outright denials — the single most common reason new clinicians can’t see insured patients and new facilities miss revenue targets in their first six months. Only 55-60% of behavioral health providers are in-network compared to 90% […]

Vermont Just Killed ABA Concurrent Billing. Michigan, Virginia, and Texas Are Next. Here’s How to Protect Your Revenue.

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| ABA

If your ABA practice bills concurrent 97153 (behavior technician time under BCBA direction) and 97155 (BCBA protocol modification) simultaneously, 2026 is the year the rules got harder — and different in every state. The biggest news: Vermont Medicaid, effective January 2026, discontinued reimbursement for concurrent billing of 97153 and 97155, restricted telehealth ABA delivery, and […]

ABA Billing 97153 & 97155 Concurrent Denials: Fix Them Now

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| ABA

Stop losing revenue on 97153 and 97155 concurrent-service denials. Learn the exact modifier, POS, and documentation fixes ABA practices need in 2026.

G0480 vs G0483 Drug Screen Coding: Stop the Revenue Leak

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| SUD

Most SUD practices misbill G0480 and G0483 drug screens, losing thousands monthly. Learn the exact coding errors and how to recover revenue fast.

G0480-G0483 Drug Screen Coding: Why Most SUD Practices Are Under-Coding and Leaving 4-5x Revenue Per Test

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| SUD

If your SUD practice runs definitive (confirmation) drug testing and 80%+ of your screens are billing as G0480, you’re under-coding the work. The G0480 to G0483 series is stratified by complexity (number of drug classes tested), and the reimbursement delta between G0480 and G0483 can be 4-5x per claim. For a residential SUD program running […]

Mental Health Parity Act Appeals: How Behavioral Health Practices Are Leaving Money on the Table

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| Behavioral Health

If your practice bills any commercial insurance — Anthem, Aetna, United, Cigna, BCBS plans — you have parity-violation denials in your queue right now. They look like routine denials. They’re not. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and the 2020 amendments require that behavioral health and substance use disorder benefits […]

Outsource ABA Billing Services: When It Pays Off (And When It Doesn’t)

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| ABA

The honest answer: Outsourcing your ABA billing makes financial sense when your collected revenue per BCBA hour is being suppressed by 4% or more in fixable categories you don’t have time to work. Below that threshold, in-house billing usually wins. Above it, you’re paying yourself to do work an outsourced team can do faster and […]

The 5 Denial Patterns Behavioral Health, ABA, and SUD Practices Lose the Most Revenue To

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| ABA

We audit a lot of behavioral health, ABA, mental health, and substance use disorder practices. The pattern is almost always the same: 8 to 12 percent of net revenue is sitting in denials that nobody had time to rework. It’s not because the billing team is bad. It’s because there aren’t enough hours in the […]

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Tag: behavioral health RCM

Behavioral Health Credentialing Timelines: Commercial vs Medicare

Telehealth Modifier 93 vs 95: What BH Practices Get Wrong

Why 40% of Mental Health Practices Get Stuck in Credentialing Purgatory in 2026 (And the Specific Fixes to Get In-Network in 90 Days Not 180)

Vermont Just Killed ABA Concurrent Billing. Michigan, Virginia, and Texas Are Next. Here’s How to Protect Your Revenue.

ABA Billing 97153 & 97155 Concurrent Denials: Fix Them Now

G0480 vs G0483 Drug Screen Coding: Stop the Revenue Leak

G0480-G0483 Drug Screen Coding: Why Most SUD Practices Are Under-Coding and Leaving 4-5x Revenue Per Test

Mental Health Parity Act Appeals: How Behavioral Health Practices Are Leaving Money on the Table

Outsource ABA Billing Services: When It Pays Off (And When It Doesn’t)

The 5 Denial Patterns Behavioral Health, ABA, and SUD Practices Lose the Most Revenue To