A Comprehensive Guide for Mental Health Billing- Part 1

Most insurance companies cover mental health services, as long as they are considered medically necessary. For example, Medicare Part B will cover mental health services as long as they are medically necessary for the diagnosis or treatment of an illness or injury. This means that medical insurance will cover mental health services, but only to a certain extent. Medical insurances are very stringent on the types of mental health benefits they provide, so if you are billing for a mental health professional, you need to be very careful.
Who can provide mental health services?
The following mental health professionals can provide psychological assessments and therapy; however, cannot generally prescribe medications (although some states will allow it):
- Clinical Psychologist
A psychologist with a doctoral degree in psychology from an accredited/designated program in psychology. Psychologists are trained to make diagnoses and provide individual and group therapy.
- School Psychologist
A psychologist with an advanced degree in psychology from an accredited/designated program in School Psychology. School Psychologists are trained to make diagnoses, provide individual and group therapy, and work with school staff to maximize efficiency in the schools setting.
Related Article: A COMPREHENSIVE GUIDE FOR MENTAL HEALTH BILLING- PART 2
The following mental health professionals can provide counseling and with proper training, assessments; however, cannot prescribe medication:
- Clinical Social Worker
A counselor with a masters degree in social work from an accredited graduate program. Trained to make diagnoses, provide individual and group counseling, and provide case management and advocacy; usually found in the hospital setting.
- Licensed Professional Counsellor
A counselor with a masters degree in psychology, counseling or a related field. Trained to diagnose and provide individual and group counseling.
- Mental Health Counsellor
A counselor with a masters degree and several years of supervised clinical work experience. Trained to diagnose and provide individual and group counseling.
- Certified Alcohol and Drug Abuse Counsellor
A counselor with specific clinical training in alcohol and drug abuse. Trained to diagnose and provide individual and group counseling.
- Nurse Psychotherapist
A registered nurse who is trained in the practice of psychiatric and mental health nursing. Trained to diagnose and provide individual and group counseling.
- Marital and Family Therapist
A counselor with a masters degree, with special education and training in marital and family therapy. Trained to diagnose and provide individual and group counseling.
- Pastoral Counsellor
Clergy with training in clinical pastoral education. Trained to diagnose and provide individual and group counseling.
- Peer Specialist
A counselor with lived experience with mental health or substance use conditions. Assists clients with recovery by recognizing and developing strengths, and setting goals. Many peer support programs require several hours of training.
- Other Therapists
A therapist with an advanced degree trained in specialized forms of therapy. Examples include art therapist, music therapist.
Related Article: COMPREHENSIVE GUIDE FOR MENTAL HEALTH BILLING- PART 3
The following mental health professionals can prescribe medication; however, they may not provide therapy:
- Psychiatrist
A medical doctor with special training in the diagnosis and treatment of mental and emotional illnesses. A psychiatrist can prescribe medication, but they often do not counsel patients.
- Child/Adolescent Psychiatrist
A medical doctor with special training in the diagnosis and treatment of emotional and behavioral problems in children. Child and Adolescent psychiatrists can also prescribe medication; however, they may not provide psychotherapy.
- Psychiatric or Mental Health Nurse Practitioner
A registered nurse practitioner with a graduate degree and specialized training in the diagnosis and treatment of mental and emotional illness.
Additionally, your Primary Care Physician, Physician’s Assistant or Nurse Practitioner (depending on your state) are often qualified to provide medication.
Under this blog series of a comprehensive guide for mental health billing, we will be covering all aspects of mental health billing. In this part, we covered mental health service providers and their area of expertise. In part 2 we will be discussing different types of mental health services and who are authorized to provide them.
E2E Medical Billing Services is assisting mental health providers to get maximum reimbursment from last 05 years. To know more about our mental health billing services you can call us at 888-552-1290 or email us at [email protected]