Introduction
Medical billing is often the most frustrating part of running a private practice for therapists. Whether you’re a Licensed Marriage and Family Therapist (LMFT), Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCSW), the challenges of billing insurance — navigating CPT codes, payer rules, denied claims, and evolving telehealth regulations — can make or break your practice’s bottom line.
At Global Tech Billing LLC, we’ve helped numerous behavioral health providers untangle these complexities. This guide is your practical roadmap to understanding and optimizing the billing side of your therapy business — so you can focus on what truly matters: caring for clients.
Billing psychiatric evaluations requires careful attention to coding. Get clarity on initial session requirements with this guide on psychiatric evaluation billing.
Why Medical Billing for Therapists Is Different
Therapists face billing challenges that general medical providers typically don’t. Here’s why:
- Licensure acceptance varies: Not all payers credential LMFTs or LPCs.
- Mental health is reimbursed differently: Coverage for therapy services often includes session limits, pre-authorization, and strict documentation requirements.
- Behavioral health denials are higher: Behavioral health claims are denied at five times the rate of physical health claims, according to a landmark Milliman study
Step-by-Step: Setting Up Your Billing System
1. Credentialing Comes First
Credentialing is required before you can bill insurance. You’ll typically need:
- State license verification
- NPI number (Type 1 for individual, Type 2 for group)
- CAQH profile
- Malpractice insurance
- Tax documents (e.g., W-9)
Credentialing can take 60–120 days per payer. Global Tech Billing LLC offers hands-on credentialing support to avoid delays, rejections, and payer miscommunication.
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2. Common CPT Codes Therapists Use
Here are the standard CPT codes therapists rely on:
| CPT Code | Description | Typical Reimbursement |
| 90791 | Intake Assessment | $120–$160 |
| 90832 | 30-minute psychotherapy session | $65–$90 |
| 90834 | 45-minute session psychotherapy | $80–$120 |
| 90837 | 60-minute psychotherapy session | $100–$160 |
| 90846/90847 | Family therapy (without/with the client) | $90–$140 |
3. Always Verify Eligibility Before Sessions
Never assume your client’s insurance hasn’t changed. Even long-term clients can lose coverage or switch plans.
Use tools like:
- Availity
- Office Ally
- Payer portals (e.g., Aetna, Cigna)
Confirm:
- Deductibles and co-pays
- Coverage for your licensure type
- Authorization requirements
- Annual session limits
4. Use Correct Modifiers and POS Codes
Modifiers and POS (Place of Service) codes are essential for telehealth billing.
| Service Type | Modifier | POS Code |
| Telehealth | 95 or GT | 10 |
| In-Office | None | 11 |
CMS and commercial insurers require POS 10 for remote sessions as of 2025.
Reference: CMS 2025 Telehealth Update
Top 5 Billing Mistakes Therapists Make
- Using the wrong CPT or taxonomy code
- Skipping eligibility verification
- Failing to re-credential on time
- Submitting claims too late (past payer deadlines)
- Under-documenting — especially for longer sessions (e.g., 90837)
According to the American Psychological Association, these errors cost small therapy practices thousands annually (APA Services).
Emergency sessions require precise coding and time tracking. Get it right with this billing guide for 90839 and 90840 crisis intervention codes.
Real-Life Case: Why One Therapist Lost $9,000
A solo LCSW in Colorado lost over $9,000 in revenue in a year due to:
- Missed timely filing limits (claims not submitted within 90 days)
- Repeated 90837 denials due to lack of supporting documentation
- Not verifying eligibility for a plan that was later termed mid-treatment
After partnering with Global Tech Billing LLC, they reduced their average claim cycle from 43 days to 15 days, and increased monthly collections by 28%.
Telehealth Billing in 2025
Telehealth is still reimbursed in most U.S. states. But to get paid, you must:
- Use POS 10 for sessions done via secure video
- Add Modifier 95
- Confirm your payer recognizes your license for telehealth
- Use HIPAA-compliant software (e.g., Doxy.me, Zoom for Healthcare)
In 2025, both Medicare and many commercial plans reimburse 90834 and 90837 for telehealth, but you must follow coding rules.
Reference: CMS Telehealth Coverage 2025
Should You Outsource or Keep Billing In-House?
| Practice Size | Sessions | In-House Feasible? | Outsource Recommended? |
| Solo (1–2 providers) | <20 | Yes | Yes, with time optional, or part time only |
| Small Group (3–5) | 30–50 | Difficult | Yes |
| Large Group (6+) | 60+ | No | Essential |
Outsourcing doesn’t mean giving up control — it means handing over the repetitive work to experts like Global Tech Billing LLC who work as a billing extension of your practice.
How Much Are You Losing?
According to the Medical Group Management Association:
- 6–12% of potential revenue is lost due to billing inefficiencies
- Denial rates for behavioral health average 15–20%
- A solo provider can lose $15,000–$20,000 annually to poor billing practices
- MGMA Insights
Should I outsource billing?
If you’re spending more than 6 hours a week on billing or seeing over 20 clients/week, outsourcing will likely save you time and increase collections.
Final Takeaway
Your therapy skills bring healing — but your billing process fuels sustainability. Don’t let poor claims management sabotage your practice. With the right CPT codes, eligibility checks, modifiers, and documentation, you can confidently bill insurance and reduce denials.
And if you’re tired of navigating this alone, let Global Tech Billing LLC help.
FAQs
1. Can I bill insurance as an LMFT?
Yes, but only if the insurance plan accepts LMFTs in your state. Some insurers credential LMFTs and reimburse for their services, while others do not. It’s essential to verify with each payer before providing services to avoid denied claims.
2. What CPT code should I use for a 60-minute therapy session?
The correct CPT code for a 60-minute individual therapy session is 90837. However, not all payers reimburse this code at the same rate—or at all—so it’s wise to confirm with the insurance company ahead of time.
3. How often should I follow up on submitted claims?
Ideally, you should check the status of submitted claims within 7–10 business days. Early follow-up can catch errors or denials in time to refile, appeal, or correct issues without missing timely filing deadlines.
4. Are telehealth sessions reimbursed at the same rate as in-person sessions?
In most cases, yes. As of 2025, many commercial and government payers reimburse telehealth sessions at parity with in-office visits, as long as they’re billed with modifier 95 and Place of Service (POS) code 10.
5. Should I outsource my billing or manage it in-house?
If you’re seeing fewer than 20 clients per week, in-house billing might be manageable. But once your caseload grows, outsourcing to a partner like Global Tech Billing LLC can save time, reduce denials, and ensure consistent cash flow.
6. What’s the difference between an NPI and taxonomy code?
Your NPI (National Provider Identifier) is a unique number that identifies you to payers. Your taxonomy code describes your specialty (e.g., LMFT, LCSW). Mismatches between these can lead to claim denials.