Testing units exceed authorization
Payer approved a set number of testing hours and the claim bills more. We request authorization from the test battery planned, reconcile units before submission and request extensions when the evaluation grows.
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Psychology medical billing services
Psychology billing turns on minutes and units. Psychotherapy codes are selected by documented time, testing is billed in hourly and half-hour increments split between evaluation, administration and technician work, and payers authorize testing by the hour. Claims pay when the note supports the minutes and the units match the authorization.
What makes psychology billing different
Psychologists bill a mix of time-based therapy and unit-based testing, and each half has its own thresholds, add-ons and payer policies.
- Psychotherapy codes 90832, 90834 and 90837 are chosen by face-to-face minutes, with 90837 requiring 53 or more, and payers flag practices that bill 90837 for nearly every session without time documented in the note.
- Psychological testing bills 96130 and 96131 for evaluation services, 96136 and 96137 for administration by the psychologist, 96138 and 96139 for a technician, and 96146 for an automated instrument, with neuropsychological testing under 96132 and 96133.
- Diagnostic evaluation 90791 is limited by most payers to once per episode of care, and interactive complexity add-on 90785 pays only with a documented communication factor, never on its own or with testing codes.
- Medicare claims from clinical psychologists carry modifier AH, telehealth sessions use POS 10 or 02 with modifier 95 as the payer directs, and health behavior codes 96156, 96158 and 96159 apply when the diagnosis is medical.
Denials we see most in psychology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Time not documented
Psychotherapy claims denied on audit because the note lacks start and stop time. We give clinicians a note checklist and review 90837 frequency so documentation supports the code chosen.
Telehealth place of service
Video sessions denied for wrong POS or missing modifier. We maintain each payer's telehealth rule, apply POS 10 or 02 and modifier 95 or GT correctly and resubmit affected claims.
How Core MB bills for psychology
Core MB runs psychology billing with a team that knows the difference between an evaluation hour and an administration hour, tracks testing authorizations by unit and watches payer frequency flags on 90837. Credentialing for new psychologists and postdoctoral staff runs in the same client portal. Credentialing for new providers runs in the same system, tracked live in your client portal.
- Testing authorizations requested with the planned battery and tracked by remaining units per patient.
- Psychotherapy sessions checked for documented minutes before the time-based code is finalized.
- Payer-specific telehealth, modifier and supervision rules maintained for every plan you accept.
Everything in the service
Every piece of the psychology revenue cycle handled in one place, from benefits and testing authorizations through claim scrubbing, denials, posting, patient statements and monthly reporting.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Psychology billing questions
Can we bill 96130 and 96136 on the same day?
Yes. Evaluation services and test administration are separate families, and the first hour of each can be billed on the same date when both are performed and documented. Units must still fit within the testing authorization, and the report should distinguish evaluation time from administration time.
Why does a payer keep requesting notes on our 90837 claims?
Payers monitor how often a practice bills the 53-minute code compared with 90834. A high 90837 share triggers records requests. We make sure every note carries start and stop times and the clinical reason for the longer session, which usually ends the review.
How is a court-ordered or custody evaluation billed?
Most forensic evaluations are not covered benefits and should be billed to the requesting party under a written agreement, not to insurance. We help you separate clinical from forensic work so insurance claims are not submitted for evaluations the plan will deny or later recoup.
How do we get started with Core MB for psychology billing?
Send your provider count, testing volume and payer mix through the quote form and we will respond with a written proposal. Transitions run alongside your current billing so sessions keep getting paid, and credentialing for new psychologists can start at the same time.
Therapy minutes and testing units billed exactly as documented
Core MB keeps psychotherapy, testing and telehealth claims aligned with payer rules so your practice is paid for the full scope of its work.