Mental Health Billing Q&A #1: Can Your Billing Company Change Your Rates?
The answer is definitely no. Your contracted rate is agreed upon when signing your each contract you have with each insurance company.
We’ve had providers demand that they be paid more as a result of our services. This is a fruitless request. The allowed amount is agreed upon as a result of the contract signed between the provider and the insurance company.
So while the CPT code use might effect the allowed amount, e.g. 90834, a 45-55 minute session vs 90837, a 55+ minute session, may have an impact as result of the services rendered, we cannot increase the amount you are paid for a 45 minute session in any way.
Hopefully this sets your expectations correctly about insurance billing and insurance billing companies. We cannot get you paid more than what you’ve agreed upon as a result of your credentialing process.
Things You Can Do
- See patients for 60 minute sessions instead of 45 minute sessions.
- Note: the price increase does not scale linearly, meaning that you will not be paid the same amount per minute for those extra 15 minutes of therapy, most often.
- Note 2: some insurance companies require authorization for sessions longer than 45 minutes, like UHC.
- Negotiate your rates with insurance companies
- Negotiate a private pay rate
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