Start a Behavioral Health Billing and Coding Consultancy

1. 1

   Master behavioral coding and denials

   Know the core behavioral CPT codes (90791 for diagnostic evaluation, 90837 and 90834 and 90832 for therapy at different lengths, plus add-on and group codes), documentation requirements, and the payer-specific rules that trigger denials. Learn the common denial reasons and how to appeal them. This depth is exactly what a generalist biller lacks and what practices will pay you for.

2. 2

   Offer coding audits

   A high-value entry service is auditing a practice's coding and claims to find under-coding, over-coding, and patterns causing denials, then quantifying the recovered or protected revenue. Audits are concrete, easy to sell, and lead into ongoing work. Showing a practice the dollars they are losing sells the rest of your services.

3. 3

   Fix denials and train staff

   Take on denial-resubmission projects to recover money already earned, and train front-desk and billing staff so the practice stops repeating the same errors. Training turns a one-time fix into a lasting improvement and a referral source. Offer both the cleanup and the prevention.

4. 4

   Package and reach clients

   Sell audits, retainers, project work, and training, and reach practices through EHR and billing-service partners, professional associations, and referrals from clinicians frustrated by denials. Your specificity is the marketing message. Being the behavioral coding expert is a clear, memorable position.

5. 5

   Know what this is not

   This is advisory and project-based coding expertise. Running the entire revenue cycle continuously is the insurance concierge card, and getting clinicians onto panels is the credentialing card. This consultancy fixes and optimizes coding and denials, and trains the people who do the day-to-day billing.

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Best for: Coders, billers, and revenue specialists who want to specialize in behavioral health

Not for: Not for a generalist who will not specialize in behavioral coding; the specificity is the moat. Not for anyone who wants to run the whole revenue cycle, which is the separate insurance concierge card, or get clinicians onto panels, which is the credentialing card. This is general information, not legal advice.