Top 6 Mental Health Billing Companies in NYC (2026)

Mental Health Billing Companies in NYC: Side by Side

The New York Rulebook for Mental Health Billing

1. 1Private practice

   The State Education Department licenses you first.

   The Office of the Professions licenses mental health counselors, clinical social workers, marriage and family therapists, and psychologists. Medicaid and commercial enrollment follow, and a clinician cannot bill a plan until both are complete.
2. 2Private practice

   Medicaid pays licensed counselors and therapists directly.

   The eMedNY policy guidelines for LCSWs, LMHCs, and LMFTs cover fee-for-service billing in private and group practice. Services by limited-permit holders are billed under the supervising clinician’s NPI.
3. 3Private practice

   Ninety days from the visit.

   eMedNY expects initial claims within 90 days of the date of service, and provider delays do not qualify for an extension, so slow charge entry can end a claim before it is sent.
4. 4Private practice

   Minutes set the code.

   Psychotherapy bills by face-to-face time using three main codes: 90832, 90834, and 90837. 90832 covers 16 to 37 minutes, 90834 covers 38 to 52 minutes, and 90837 covers 53 minutes or more. A note without start and stop times invites a downcode, and every claim needs ICD-10-CM diagnosis codes from a DSM-5 diagnosis that supports medical necessity.
5. 5Private practice

   Evaluations and add-ons follow their own codes.

   90791 and 90792 are evaluations, reported once rather than by the minute, and 90785 adds interactive complexity. When a prescriber adds therapy to an E/M visit, 90833, 90836, and 90838 use the same time bands. Crisis, family, group, and testing services use 90839, 90840, 90846, 90847, 90853, and 96130 to 96139, each with its own documentation rules.
6. 6Clinics and CCBHCs

   Article 31 and Article 32 clinics bill at APG rates.

   OMH-licensed outpatient clinics under Part 599 and OASAS-certified outpatient programs under Part 822 are paid through Ambulatory Patient Group rates, so the rate code, procedure code, and peer group determine payment. The OMH and OASAS billing manual sets out the combinations.
7. 7Clinics and CCBHCs

   Medicaid managed care must pay the government rate.

   New York requires Medicaid managed care plans to pay at least the fee-for-service government rates for OMH and OASAS outpatient programs, so a clinic should expect the same APG rate whichever plan covers the member.
8. 8Clinics and CCBHCs

   Commercial plans now owe clinics a floor.

   Under Part AA of Chapter 57 of the Laws of 2024, insurers must reimburse in-network OMH and OASAS facilities for covered outpatient services at no less than the Medicaid rate, and OMH publishes the rate exhibits each year.
9. 9Clinics and CCBHCs

   CCBHCs bill a daily rate.

   CCBHC Medicaid claims use a unique rate code, 1147, and a clinic-specific daily rate, and a CCBHC may run a separate Article 31 clinic at the same site billed at the APG rate. The state’s CCBHC billing guidance explains how the two programs are kept apart.
10. 10Clinics and CCBHCs

    Part 2 raises the privacy bar.

    Substance use disorder records carry confidentiality rules beyond HIPAA, and the compliance date for the 2024 update was February 16, 2026. New York adds Mental Hygiene Law section 33.13 for clinical records at licensed programs, so a billing partner needs written rules for what it receives and shares.
11. 11Clinics and CCBHCs

    Authorization and level of care drive payment.

    Residential, partial, and intensive outpatient programs depend on utilization review. Levels of care follow the ASAM criteria, and facility claims usually go on the UB-04 with revenue codes, not the CMS-1500 that practices use.
12. 12Clinics and CCBHCs

    ABA runs on units.

    Applied behavior analysis bills adaptive behavior codes such as 97151 to 97158 in 15-minute units, so authorizations are counted in units and tracked as they are used.
13. 13Medicaid managed care

    HARP members carry extra services.

    Health and Recovery Plans serve adults with high behavioral health needs and add CORE and BH HCBS services on top of the full benefit package, billed under the same OMH and OASAS managed care manual.
14. 14Medicaid managed care

    Every plan keeps its own panel.

    Mainstream Medicaid managed care plans and HARPs each maintain a provider panel, and enrollment with one plan does not carry to another.
15. 15Medicare and commercial

    Medicare Part B routes through National Government Services.

    New York professional claims go to the contractor for the Northeast, and counselors and marriage and family therapists have been able to bill Medicare directly since January 1, 2024.
16. 16Medicare and commercial

    Telehealth from home is covered.

    Medicare lets patients receive mental health services by telehealth at home, with the in-person requirement on hold through 2027. Claims use place of service 10 for the patient’s home and 02 elsewhere, and many plans expect a modifier such as 95.
17. 17Medicare and commercial

    Integration and digital codes follow their own rules.

    Psychiatric Collaborative Care bills under 99492 to 99494, general behavioral health integration under 99484 and G0323, and digital mental health treatment devices under G0552 to G0554, each with time thresholds and a treatment plan on file.
18. 18Medicare and commercial

    Parity law still applies.

    Federal parity law and New York’s Timothy’s Law require comparable coverage for mental health and medical care. Federal enforcement of the 2024 update’s new provisions has been paused since May 2025, but the underlying law remains in force.
19. 19Medicare and commercial

    Behavioral health panels differ.

    Many commercial plans carve behavioral health out to separate managed behavioral health organizations, such as Optum, Carelon Behavioral Health, and Magellan, with their own credentialing panels.
20. 20Medicare and commercial

    Out-of-network claims have two layers.

    The No Surprises Act requires a good faith estimate for self-pay and uninsured patients, and New York has its own surprise-bill protections handled through the Department of Financial Services.

Where New York Claims Break

How to Test a Mental Health Billing Company in NYC

Signals to Walk Away From

• A percentage quoted on billed charges instead of collections
• A promise to credential you with every plan in a fixed number of days
• Collection rate promises with no New York client data behind them
• Strong professional billing answers paired with vague APG or CCBHC ones
• No read-only access to your own claim and payer systems

Build In-House or Outsource?

Compliance Essentials Your Biller Should Already Know

What Does Mental Health Billing Cost in NYC?

Mistakes New York Practices Make

1. 1

   Hiring a general biller for a clinic.

   Professional claims and APG clinic claims are different jobs. A biller who learned one will lose revenue on the other.
2. 2

   Missing the 90-day window.

   eMedNY counts from the date of service and does not excuse provider delays, so slow charge entry or a credentialing gap can end a claim before it is sent.
3. 3

   Letting plans pay below the floor.

   Commercial plans must pay in-network OMH and OASAS clinics at least the Medicaid rate. Ask whether your biller compares each payment with the published rate.
4. 4

   Billing a limited-permit clinician under the wrong NPI.

   Services by supervised clinicians follow the supervising clinician’s NPI under the Medicaid policy. Confirm each plan’s rule before the first claim.
5. 5

   Skipping the reference calls.

   Two conversations with New York practices or programs like yours tell you more than any proposal.

How We Ranked These Companies

Final Picks: Which One Fits You?

• TruCare if you want billing and credentialing on one record with a published rate.
• BellMedEx if you run an Article 31 clinic or community program and need APG, HARP, and CCBHC billing.
• MedStates if you want a Manhattan team and a fee range you can estimate.
• O’Brien’s Billing if you want a seasoned family firm for a solo or small-group practice.
• TheraThink if you want a mental-health-only biller and a free trial.
• Billing Nerds if you want billing and credentialing from a Brooklyn team.

Frequently Asked Questions

TruCare Service Details

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