Mental Health Billing: Do Sessions Need to be Pre-Authorized?

Earlier, we discussed if insurances pay mental health providers well and how long it would take to get reimbursed.

If you are a mental health/behavioral health professional, working in private or group practice, you will have your work cut out for you. If you’re like many, you have your plate full. Finding time for the clients, in addition to handling all of the administrative tasks, can become quite stressful.

Additionally, perhaps you are wondering if sessions need to be pre-authorized?

We talked to the Senior Medical Biller at Thriveworks, Alicia Potts, and she gladly shared her knowledge with us.

Do sessions need to be pre-authorized?

“Typically, with most insurance companies, a basic office visit, therapy session, even the initial session, do not need authorization” says Alicia. “But it is always best to check to make sure.”

Generally, for the basic stuff, you do not need authorization, but always check.

Quick Tip

When in doubt, check it out. Tufts insurance almost always requires authorization for a claim. If it is psychiatry testing, you always need to obtain an authorization.

One More Tip

Some insurance companies like BCBS of Mass only allow up to 12 visits and then you are required to get an authorization.

For more information:

UPDATE 09/2014: To focus on providing excellent medical billing to Thriveworks franchises, we are no longer providing billing services to non-Thriveworks practices.

Learn more about the exciting benefits of opening a Thriveworks Counseling center in your area, here: Counseling Franchise.


Your Friends at Thriveworks

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Dr. Anthony Centore

Anthony Centore, PhD

Anthony Centore, PhD, is Founder and Chair at Thriveworks — a counseling practice focused on premium client care, with 340+ locations across the US. Anthony is a Private Practice Consultant for the American Counseling Association, columnist for Counseling Today magazine, and author of "How to Thrive in Counseling Private Practice". He is a multistate Licensed Professional Counselor (LPC) and has been quoted in national media sources including The Boston Globe, the Chicago Tribune, and CBS Sunday Morning.

Check out “Leaving Depression Behind: An Interactive, Choose Your Path Book” written by AJ Centore and Taylor Bennett."