Behavioral Health & Psychiatric Billing Services in Florida

Behavioral Health & Psychiatric Billing Services for Florida Practices

Maximum Billing, LLC provides specialized revenue cycle management and billing services for behavioral and mental health practices across Florida. From solo therapists in Sarasota to multi-provider psychiatry groups in Tampa, Orlando, Jacksonville and Miami, we help you get paid accurately and on time so you can focus on patient care.

Our team handles the full billing lifecycle for behavioral health, including insurance verification, claims submission, payment posting, denial management, and credentialing. We understand the unique coding and payer requirements that come with therapy, counseling, psychiatry, and medical billing for behavioral and mental health — and we know the Florida payer mix your practice actually bills, from Florida Blue and the Statewide Medicaid Managed Care plans to TRICARE East.

Maximum Billing has specialized in mental health billing since 2018, backed by more than 20 years of hands-on experience in insurance billing and revenue management. Behavioral health is not a sideline for us. It is the work we do every day.

What We Offer

• Behavioral health revenue cycle management
• Mental health and therapy billing
• Psychiatry and medical billing
• Insurance verification and eligibility checks
• Clean-claim submission and denial management
• Payment posting and provider credentialing
• Accounts receivable follow-up and appeals
• EFT and ERA enrollment
• Patient balance billing and statements

Why Psychiatric and Behavioral Health Billing Is Different

Behavioral and mental health billing comes with challenges that general medical billing simply doesn’t face. Session-based coding, time-based CPT codes, telehealth modifiers, prior authorizations, and strict payer documentation rules all create opportunities for denials and lost revenue. Our team specializes in these nuances so your claims are submitted correctly the first time.

Three differences cause most of the revenue leakage we see when a Florida practice hands us its accounts receivable:

• Time is the code. In most specialties the procedure determines the code. In psychotherapy, the clock does. A session documented at 52 minutes and one documented at 53 minutes bill as two different codes at two different rates, and a note that records only “1 hour” will not support either one on audit.
• Behavioral health is often carved out. A patient’s medical benefits and behavioral benefits are frequently administered by different companies, with different claim addresses, different authorization rules and different portals. Verifying the medical side alone tells you very little about whether the session will be covered.
• Visit limits and authorizations are routine. Ongoing therapy, psychological testing and intensive outpatient care are all commonly subject to a visit cap or a concurrent review. These are usually preventable denials, but only if someone is tracking the count before the session, not after the rejection.

We work as an extension of your practice, giving you transparent reporting, responsive communication, and a billing partner who understands the realities of running a therapy, counseling, or psychiatry practice.

The CPT Codes Behind a Behavioral Health Claim

Getting paid in behavioral health starts with choosing the right code and supporting it in the note. These are the code families we work in daily for Florida practices:

• Diagnostic evaluations — 90791 and 90792. The distinction is medical services. A psychiatrist or psychiatric ARNP performing an evaluation with a medical component bills 90792; a therapist, counselor or psychologist bills 90791. Many payers reimburse only one per episode of care, per provider.
• Psychotherapy — 90832, 90834 and 90837. Sixteen to 37 minutes, 38 to 52 minutes, and 53 minutes or more. 90837 draws more payer scrutiny than any other code in the specialty, and practices that bill it heavily should expect records requests.
• Psychotherapy with medication management — 90833, 90836 and 90838. These are add-on codes, reported alongside an E/M code such as 99213 or 99214 rather than on their own. Billing them standalone is an automatic denial.
• Medication management — 99212 through 99215. Prescriber visits, now selected on medical decision-making or total time.
• Family and group — 90846, 90847 and 90853. Family therapy with and without the patient present, and group psychotherapy. Coverage for 90846 varies widely by plan.
• Crisis — 90839 and 90840. The first 60 minutes and each additional 30, for urgent presentations. These are not interchangeable with a long psychotherapy session.
• Psychological and neuropsychological testing — 96130, 96131, 96136, 96137 and 96146. Evaluation services and test administration are billed separately, in units, and are among the most frequently authorized services in the specialty.
• Screening — 96127. Brief emotional and behavioral assessments such as the PHQ-9 or GAD-7, billable in addition to the visit when payer rules allow.

Our coding review happens before the claim goes out, not after a denial comes back. If you want a deeper walkthrough, our guide to behavioral health billing and coding covers the fundamentals.

The Florida Payer Landscape

Florida behavioral health practices bill a payer mix that looks different from other states, and every plan brings its own rules.

On the commercial side, Florida Blue is the dominant carrier in most of the state, and its behavioral health benefits are frequently administered through a separate behavioral health vendor rather than the medical plan. Aetna, Cigna and Evernorth Behavioral, UnitedHealthcare and Optum Behavioral Health, and Humana round out the commercial mix. Each has its own position on telehealth place-of-service, on 90837 documentation, and on whether a supervising provider may bill for an associate’s work.

Florida Medicaid is delivered almost entirely through Statewide Medicaid Managed Care plans administered under the Agency for Health Care Administration — plans such as Sunshine Health, Simply Healthcare, Humana Healthy Horizons and Aetna Better Health of Florida. Behavioral health services under these plans often use HCPCS codes alongside standard CPT, carry their own authorization requirements, and require enrollment in Florida Medicaid before a single claim can be submitted.

Florida also sits in the TRICARE East region, administered by Humana Military, which matters for practices near Jacksonville, Pensacola, Tampa and the Panhandle’s military communities. And with the state’s large retiree population, Medicare and Medicare Advantage are a meaningful share of psychiatric billing in South Florida, Naples, Sarasota and The Villages.

Knowing which of these is the actual payer — and which entity actually processes the behavioral claim — is the difference between a clean claim and a 45-day detour.

Telehealth Billing for Florida Behavioral Health Practices

Telehealth is now permanent infrastructure in behavioral health, not a temporary accommodation, and a large share of the Florida practices we support deliver most of their sessions virtually. It is also one of the easiest places to lose money on a technicality.

Place of service is the most common error. POS 10 identifies telehealth delivered to the patient in their home; POS 02 identifies telehealth delivered somewhere other than the home. They often reimburse at different rates, and payers do not agree on which they want. Modifier 95 is required by most plans, while some still expect other modifiers, and a handful want no modifier at all with the correct POS.

Audio-only sessions add another layer, since coverage and modifier rules differ from video by plan and by line of business. We track these requirements payer by payer so your virtual sessions are billed the way that specific plan expects.

Credentialing and Enrollment for Florida Clinicians

A credentialing gap is the most expensive administrative problem a growing practice can have, because the sessions still happen — they just can’t be billed. Florida adds its own wrinkles.

The state licenses LMHCs, LCSWs and LMFTs under Chapter 491 and psychologists under Chapter 490, and payers treat these license types differently in terms of panel access and reimbursement. Florida’s registered interns — RMHCIs, RCSWIs and RMFTIs accruing hours toward licensure — are a particular sticking point, because most commercial plans will not panel them and the rules on billing their sessions under a supervisor vary by payer and are easy to get wrong in a way that invites recoupment.

We handle CAQH setup and re-attestation, commercial panel applications, Florida Medicaid enrollment, group versus individual contracting, and adding new clinicians to an existing group contract. Our mental health credentialing services page explains what the process involves and how long it realistically takes. For the full process, see our behavioral health credentialing services. Our Florida Medicaid provider enrollment guide covers the AHCA process, including the group requirement for therapists.

Denial Management and Aging Accounts Receivable

Most behavioral health denials fall into a short list of recurring causes: eligibility that lapsed or changed at the start of the year, a missing or exhausted authorization, a behavioral carve-out sending the claim to the wrong payer, a time-based code that doesn’t match the documented duration, an add-on code billed without its primary, a telehealth POS or modifier mismatch, or a taxonomy or NPI problem on the provider record.

Because the causes repeat, the fix is systematic rather than heroic. We work denials by root cause, appeal what should be paid, and close the upstream gap so the same denial stops recurring. For practices that come to us with aged receivables, we start by triaging the balances still inside timely filing — those are the dollars most often recoverable. You can read more on claims denial management and the most common rejections in mental health billing.

Who We Serve

We support a wide range of behavioral and mental health providers, including licensed therapists and counselors, psychologists, psychiatrists and psychiatric nurse practitioners, group practices, substance use and addiction treatment centers, and telehealth-based providers. Whatever your specialty, we tailor our billing workflow to fit your practice.

That includes solo clinicians who need someone reliable handling claims while they build a caseload, growing group practices adding associates faster than their admin staff can keep up, and established multi-provider psychiatry groups that need a billing partner rather than a clearinghouse.

Serving Behavioral Health Practices Across Florida

Billing is not geographically constrained, so we work with practices throughout the state — Tampa, St. Petersburg and Clearwater; Orlando and Central Florida; Jacksonville and the First Coast; Miami, Fort Lauderdale and West Palm Beach; Naples, Fort Myers and Sarasota; and Tallahassee, Gainesville and the Panhandle. Practices outside Florida are welcome too; see our Florida medical billing services and Texas medical billing services pages, or our full list of billing services.

Benefits of Partnering With Us

• Faster reimbursements through clean, accurate claim submission
• Fewer denials thanks to proactive eligibility and authorization checks
• Reduced administrative burden so clinicians can focus on patients
• Clear, easy-to-understand financial reporting
• Specialized knowledge of behavioral and mental health payer requirements
• Familiarity with the Florida commercial, Medicaid managed care and TRICARE landscape
• Support for solo practitioners and large multi-provider groups alike

Psychiatry Billing for Florida Psychiatrists and Psychiatric Nurse Practitioners

Psychiatry billing is its own discipline inside behavioral health. A therapy practice bills mostly time-based psychotherapy codes. A psychiatric practice bills evaluation and management (E/M) visits, often with psychotherapy added on, and the rules for combining the two are where psychiatry medical billing most often goes wrong.

• E/M plus psychotherapy add-ons. A medication management visit billed as 99213 or 99214 can carry add-on code 90833, 90836, or 90838 only when the psychotherapy time is documented separately from the time spent on the E/M service.
• 90792 versus 90791. A psychiatric diagnostic evaluation that includes medical services, such as a medication assessment, is billed as 90792, which is limited to clinicians licensed to provide medical services, such as psychiatrists and psychiatric nurse practitioners.
• Psychiatric nurse practitioners. PMHNPs bill under their own NPI and credentials, and payer rules for their reimbursement can differ from those for psychiatrists.
• Collaborative care. Practices that work alongside primary care can bill the psychiatric collaborative care codes (99492 to 99494) when the program requirements are met.

Many mental health billing companies are built around therapy practices and treat psychiatry as an afterthought. As a behavioral health billing company that handles both, our behavioral health billing services cover psychiatric E/M visits, add-on psychotherapy, and therapy sessions under one set of rules, so billing for behavioral health services stays consistent whether or not the clinician prescribes.

Choosing a Mental Health Billing Company in Florida

Most practices start looking for mental health billing services at the same point: claims are going out late, authorizations are lapsing, and nobody has time to work the aging report. What you are really choosing between is a general medical biller who will take behavioral health on as a side line, and a mental health billing company that works these codes and these payers every day.

The difference shows up in the details. A behavioral health billing agency that knows this specialty verifies the carve-out before the first session, tracks authorization units instead of discovering they ran out, documents time so that 90837 survives review, and already knows which Florida plans hand behavioral benefits to a separate managed behavioral health organization. A generalist finds all of that out the expensive way, on your claims.

Maximum Billing, LLC has provided mental health billing services since 2018, backed by more than 20 years in insurance billing and revenue management. Behavioral health is not a side line here — it is most of what we do.

Frequently Asked Questions

How do you help reduce claim denials?

We verify insurance eligibility and benefits before appointments, confirm required authorizations, and review claims for coding accuracy prior to submission. When denials do occur, we manage the appeals and resubmission process to recover your revenue.

Do you handle telehealth billing?

Yes. We stay current on telehealth codes, modifiers, and payer-specific policies so your virtual behavioral health sessions are billed and reimbursed correctly, including the place-of-service distinctions that trip up so many behavioral health claims.

Can you help with credentialing?

Absolutely. We assist with provider credentialing and enrollment so you can join payer networks and start seeing insured patients without unnecessary delays. That includes CAQH maintenance, commercial panels, Florida Medicaid enrollment, and adding associates to an existing group contract.

Do you work with Florida Medicaid managed care plans?

Yes. Florida Medicaid is delivered through Statewide Medicaid Managed Care plans, and we bill behavioral health services to these plans regularly. Each has its own authorization requirements and code sets, and enrollment in Florida Medicaid has to be in place before claims can be submitted.

Can you bill for registered interns working toward licensure?

It depends on the payer. Most commercial plans in Florida will not panel a registered intern, and the rules for billing their sessions under a supervising licensee vary considerably from plan to plan. We review your specific contracts and tell you what each payer will and will not accept before the sessions are billed, rather than after a recoupment letter arrives.

Do you only work with psychiatric practices?

No. We bill for the full behavioral health spectrum — therapy and counseling, psychology and testing, psychiatry and medication management, and substance use treatment — as well as dental practices.

What if we already have aged accounts receivable?

That is a common starting point. We triage your aging first, prioritizing balances still within timely filing limits, work those claims to resolution, and fix the upstream process so the backlog does not rebuild.

How do I get started?

Getting started is simple. Contact Maximum Billing, LLC for a consultation, and we’ll review your current billing process and show you how we can help improve your revenue cycle.

Ready to streamline your behavioral health billing? Contact Maximum Billing, LLC or call 800-820-0364 to learn how we can support your practice. See also our behavioral health and psychiatric billing in Texas. Solo therapists and counseling groups can also see our therapy billing services.