1. Understand Service Types
✔ Includes therapy sessions, psychiatric evaluations, and medication management
✔ Covered under CPT codes 90791, 90834, 90837, and others
✔ Session duration must match billed codes (30, 45, 60 mins, etc.)
2. Insurance & Coverage Checks
✔ Verify coverage for mental health services under behavioral health benefits
✔ Identify authorization or referral requirements before scheduling
✔ Confirm patient visit limits, copays, and telehealth eligibility
3. Documentation Requirements
✔ Note start/end times, treatment goals, and session content
✔ Include DSM-5 diagnosis and medical necessity
✔ Maintain progress notes to support ongoing care and claims
4. Billing Considerations
✔ Use appropriate modifiers for telehealth (e.g., 95 or GT)
✔ Bill under supervising physician if required by plan
✔ Follow payer-specific rules for group vs. individual therapy
5. Common Challenges & Fixes
| Challenge | Fix |
| Claim denied for missing documentation | Ensure clinical notes support diagnosis and session time |
| Coverage confusion between payers | Verify mental health benefits separately from medical plan |
| Denied telehealth claims | Confirm payer guidelines and apply correct modifiers |
| Exceeded session limits | Track visits per plan and request extensions early |
