Benefits verification is the single most preventable source of claim denials in behavioral health. Ten minutes on the phone before the first session eliminates most of the problems that cost hours to fix later.
Preview — full worksheet includes 10 sections, 50-state prompt pay, CPT checkboxes, and print-ready formatting.
We'll call the payer and document the full verification on your behalf. Typically 45 minutes to one hour of prepaid time.
Request Verification →These aren't errors. They're tactics. Carriers use denial codes as a first-pass filter because most clinicians don't appeal — and the carriers know it. The appeal rate for behavioral health claims sits under 12%.
| Code | Description | Severity | Freq. |
|---|---|---|---|
| CO-97 | Service included in primary procedure / not separately payable | High | 34% |
| CO-4 | Modifier required to complete adjudication | Moderate | 22% |
| CO-50 | Non-covered — not deemed medically necessary | High | 19% |
| PR-2 | Deductible amount not met | Moderate | 14% |
| CO-16 | Claim lacks required information to adjudicate | Moderate | 11% |
Source: CMS CARC/RARC data, behavioral health segment. Frequencies approximate.
"I had six months of denials just sitting in a folder. Cameron worked through them in two weeks. I got paid for sessions I had completely written off."
— Private practice LICSW, Providence, RI
Direct links to carrier portals, verified CPT code references, and denial code documentation — maintained for behavioral health private practice. No aggregators. No outdated PDFs.
| CPT | Description | Time | Notes |
|---|---|---|---|
| 90837 | Psychotherapy, individual | 53+ min | Most common — standard session |
| 90834 | Psychotherapy, individual | 38–52 min | Shorter session; must document time |
| 90832 | Psychotherapy, individual | 16–37 min | Brief sessions; prior auth often required |
| 90791 | Psychiatric diagnostic evaluation | — | Intake / diagnostic evaluation |
| 90792 | Psychiatric diagnostic eval w/ medical services | — | For prescribers with medical component |
| 90847 | Family psychotherapy with patient present | 50 min | Identify IP carefully for insurance billing |
| 90846 | Family psychotherapy without patient present | 50 min | Varies by payer — verify coverage |
| 90853 | Group psychotherapy | — | Multiple clients, one code per client |
| H0004 | Behavioral health counseling — SUD | — | Medicaid / SUD treatment track |
| 99213 | E/M — established patient, low complexity | 20–29 min | Add-on if medical services included |
$45 per hour. Prepaid. No contract. No percentage of recovery. Just results on claims you've already earned and shouldn't have to fight for.
Or email directly: [email protected]
HIPAA-compliant intake available on request.