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Private Practice RCM

Therapy Billing
for Private Practices

More session time. Less paperwork. More revenue.

Reclaim your clinical hours and maximize practice revenue with automated billing, proactive authorization tracking, and specialized telehealth compliance. Revix MD acts as your virtual back office — logging directly into your existing EHR to secure your earned income while you focus on patient outcomes.

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The Three Pressure Points

Navigating the Complexity of Psychotherapy Billing

Therapy billing has three structural pressure points: time-based CPT thresholds, NPI hierarchy, and telehealth place of service distinctions. We manage these nuances at the configuration level to prevent recoupments before they occur.

Time-Based CPT Thresholds

Payers enforce precise minute thresholds for psychotherapy. We ensure your documentation for 90834 (38–52 min) and 90837 (53+ min) includes exact start/stop times and medical necessity narratives to withstand “upcoding” audits.

NPI Hierarchy & Group Practice Scaling

Whether you are a solo LLC or a multi-clinician group, we manage the mapping of your Individual Type 1 NPI and Group Type 2 NPI. We ensure that Box 33a and Box 24J on your CMS-1500 claims are perfectly synchronized to prevent the “Provider Not Recognized” denials that often stall growing practices.

Telehealth Place-of-Service Accuracy

We append the correct modifiers (such as 95 or 93) for POS 02 and POS 10 (Patient’s Home) services to ensure your claims align with current CMS and commercial payer telehealth reimbursement policies. This prevents the “Invalid POS” rejections that have become common as COVID-era waivers expire.

Specialty-Specific Patterns

Including modifiers and crisis add-ons

Every Therapy Code We Manage

90791

Psychiatric Diagnostic Evaluation (Initial Intake)

90832

30-Minute Psychotherapy

90834

45-Minute Psychotherapy

90837

60-Minute Psychotherapy

90846

Family Therapy (Without Patient)

90847

Family Therapy (With Patient)

90853

Group Psychotherapy

90839

Crisis Psychotherapy

90840

Crisis Add-on Session

+ More

Modifiers, add-ons & specialty codes

Four Core Solutions

Core Therapy Revenue Cycle Solutions

Eligibility Verification And Payer Carve Out Management

Eligibility Verification & Payer Carve-Out Management

Mid-month insurance changes cause most “patient owes” surprises. We perform proactive eligibility checks and navigate complex behavioral health carve-outs, confirming coverage before the session so copay and deductible collections are accurate.

Optum / UHC BehavioralCarelonMagellanEvernorth
Proactive Authorization And Session Limit Tracking

Proactive Authorization & Session-Limit Tracking

We implement a proactive alert system for managed care authorizations. By tracking session caps (such as 12 or 20 visits), we ensure you never provide a session that hasn’t been pre-authorized eliminating “Exceeded Benefit” rejections.

Out Of Network And Payer Ready Superbills

Out-of-Network & Payer-Ready Superbills

For private-pay or hybrid practices, we remove the administrative weight of superbills. We automate the generation of accurate, payer ready superbills or submit OON claims directly — reducing client friction and increasing your practice’s perceived value.

Patient Billing And Statement Management

Patient Billing & Statement Management

Therapists shouldn’t have to be debt collectors. We manage patient statements, payment plan coordination, and balance billing — ensuring high-deductible plans are managed transparently so you aren’t chasing fees months after the session.

Practice Integrity

Audit-Proof Compliance & Practice Integrity

We act as your practice’s final line of defense against payer recoupments and regulatory hurdles — integrating compliance into every step of the revenue cycle.

CAQH Profile Maintenance

CAQH ProView requires re-attestation roughly every 120 days. We handle this quarterly cadence so your insurance contracts remain active and credentialing is never at risk.

Rendering vs. Supervising Provider Compliance

For group practices utilizing pre-licensed associates (LPC-A, LMSW, MFT-I), we manage the specific modifier and signature requirements to ensure associate billing follows state-specific scope-of-practice rules.

MHPAEA & Parity Advocacy

We leverage our expertise in the Mental Health Parity and Addiction Equity Act to challenge systemic denials where payers fail to provide equitable behavioral health reimbursement.

ICD-10 to CPT Linking

We rigorously check that diagnostic codes are linked correctly to your CPT codes bypassing “Inconsistent with Procedure” rejections that quietly erode reimbursement.

15-Day Transition

Seamless 15-Day Transition Timeline

A phased onboarding designed to recover revenue while integrating quietly behind your existing tools.

Phase One

Workflow & Audit

Deep-dive audit of your current therapy coding and aging A/R. We identify revenue leaks within seven days.

Phase Two

Secure EHR Sync

Our team plugs into your platform Simple Practice, TherapyNotes, or TheraNest through encrypted connections.

Integration

Configuration Optimization

Custom coding rules and session tracking alerts are built into your billing layer for clean first-pass claims.

Phase Four

Revenue Recovery

An A/R recovery project tackles unpaid or abandoned claims from the last six months to reclaim earned income.

A Team Built for Behavioral Health

Specialized Therapy Billers Not Generalists

Every member of your dedicated Revix MD pod has been trained specifically on behavioral health coding, parity law, and the unique workflows of psychotherapy practices. We don’t service primary care on Tuesday and therapy on Wednesday — therapy is what we do.

Dedicated account lead — not a rotating call center

Behavioral health certified billing specialists

Direct Slack or email access during business hours

Monthly performance reviews with action plans

Your Revenue, Recovered

Stop Losing Revenue Between Sessions

Every unbilled session and missed authorization is money you already earned. Let us show you where it’s going.

Get Your Free Billing Audit

Frequently Asked Questions

Yes. Revix MD specializes in working directly within your existing software. We eliminate the need for messy data migrations by integrating our experts into your current digital workflow.

We offer a transparent, percentage-of-collections model. This aligns our success with yours; we only get paid when you get paid. There are no hidden per-claim flat fees.

Yes. We navigate the specific rendering vs. supervising provider requirements that vary by state and payer, allowing your group practice to scale safely and compliantly.

While insurance does not cover no-shows, we manage the patient billing process to ensure your office policies are enforced and collected, protecting your valuable clinical time.

We can automate the generation of superbly accurate superbills for your patients or submit OON claims directly to the payer, reducing the friction for your private-pay clients and increasing your practice’s perceived value.