TMS Therapy & Psychiatry Billing Services
At MNH, we understand that managing the full revenue cycle for TMS, SPRAVATO® and psychiatric billing within today’s complex healthcare billing system requires specialized expertise to ensure accurate claims submission, compliant documentation, and timely insurance reimbursement. Patients are often caught in the middle of this process and may incur charges not covered by their mental health insurance benefits or third-party payer policies.
TMS and SPRAVATO®
billing services differ significantly from traditional medical billing. Mental health claims are commonly processed through third-party payer networks such as Carelon Behavioral Health or Magellan, which follow distinct authorization and reimbursement guidelines. Despite mental health parity laws, reimbursement for
TMS therapy and psychiatric services is often lower than for physical health care, making it critical to partner with not only a billing provider that specializes in behavioral health revenue cycle management, but an expert billing agency who knows
TMS and
SPRAVATO® and treats your practice as their own.
Metro NeuroHealth is fully compliant with HIPPA
Reduce Overhead
Increased Collections
Practice Management Solutions
Web Access
HIPAA Compliance
Let us put our experience to work for you.
Reduce Overhead & Increase Revenue
Maintaining an in-house biller creates substantial overhead, including employee wages, benefits, payroll taxes, paid time off, workers’ compensation, and ongoing training costs. In addition, medical billing software, clearinghouse fees, and system maintenance generate recurring monthly expenses. When internal billing staff are unavailable due to illness, vacation, or turnover, your claims processing and revenue cycle management can come to a complete halt, leading to delayed reimbursements and lost income.
Outsourcing to a specialized
TMS,
SPRAVATO® and psychiatry billing company streamlines operations, reduces administrative burden, and improves collections. Our performance-based, sliding-scale billing model aligns with your success — the more we collect, the less you pay — delivering efficient, cost-effective medical billing solutions that maximize profitability and stabilize your cash flow.
Increased Collections
MNH is a proven leader in TMS, SPRAVATO® and psychiatry billing services, delivering rapid claims submission within 48 hours of receiving your superbill and aggressive follow-up on unpaid insurance claims. Our clients consistently report a 30–50% increase in collections and significantly improved cash flow through our expert revenue cycle management and denial prevention strategies.
Practice Management Solutions
MNH offers a full spectrum of TMS and SPRAVATO® clinic and psychiatry practice management solutions focused on optimizing revenue cycle performance and reducing administrative burden. Clients may choose their own EHR system, while MNH delivers time- and cost-saving services including benefits and eligibility verification, prior authorization management, denial mitigation, and specialized TMS patient intake services to ensure accurate billing and timely insurance reimbursement for all services rendered.
HIPAA Compliance
MNH understands that clients require a billing service provider that is fully HIPAA-compliant and adheres to all Health Insurance Portability and Accountability Act regulations. We prioritize the protection of patient privacy, the security of protected health information (PHI), and the safe management of all sensitive data across our medical billing and revenue cycle services.
4 Common TMS Therapy Billing Challenges
Steps for Patient Intake Are Not Followed
The TMS billing process starts with the patient consultation visit. It is critical to obtain the necessary information needed to successfully submit a TMS prior authorization and minimize denials and peer-to-peer reviews.
Poor Documentation Causes Delays and Denials
All MNH billing clients may access optional virtual training to support compliant documentation and optimized patient intake workflows so we can place patients in your TMS chair faster and secure accurate timely insurance reimbursement.
Not all Payer Networks are the Same
Every payer network differs, making it essential to understand coverage rules and expectations. MNH's specialized TMS patient intake program builds strong payer knowledge and strategic relationships, giving your practice a competitive edge.
Stay on Top of Changing Payer Guidelines
TMS and SPRAVATO® payer guidelines change frequently. Therefore, it requires continuous research to stay in-the-know. MNH remains abreast of the updated guidelines, which is key to the prior authorization and billing process.
Specialists in
TMS, SPRAVATO®, & Psychiatry Billing
The revenue cycle starts with the benefits and eligibility check, moves to the prior authorization phase, and crosses the finish line with the electronic fund transfer.
Reduce Overhead & Increase Collections
Access Your Billing From Anywhere
Now is the time to maximize your clinic’s growth and financial performance. MNH’s specialized TMS, SPRAVATO® and Psychiatry Billing Services are designed to lower operational billing costs, improve revenue capture, and increase your net profit. Our team is readily accessible and can begin optimizing your billing systems in less than two weeks. Contact us today to learn how we can help strengthen your revenue cycle and position your TMS practice for long-term health and profitability.
OUR SERVICES
Interventional Psychiatry, TMS, SPRAVATO® Clinic
Billing Services
The Art & Science of TMS Therapy & Spravato Billing
We work with payer networks from California to Maine
TMS Patient Intake Process
TMS Prior Authorizations
TMS Billing & Collections
Benefits & Eligibility Checks
Electronic Health Records
Revenue Cycle Management
TMS therapy and SPRAVATO® billing require advanced expertise and in-depth knowledge of patient intake, prior authorization, and payer approval processes. Even experienced psychiatry billing agencies often lack the specialized skill needed to effectively bill for TMS and SPRAVATO® services. Successful reimbursement depends on precise documentation, understanding why claims are denied, and knowing how to work directly with payer networks to ensure claims are processed and paid.
This is where MNH TMS & Psychiatry Billing Services stands apart. As former TMS clinic owners, we bring real-world experience in every aspect of the TMS and SPRAVATO® intake and authorization process, delivering higher approval rates and increased reimbursement.
Frequently Asked Questions
Here are some common questions providers have regarding psychiatry, TMS, and SPRAVATO® patient intake and billing processes.
What is the process for patient intake for TMS therapy?
The patient intake process for TMS therapy involves a comprehensive assessment, including medical history, current medications, and a review of previous treatments. Ensure all necessary documentation is collected to facilitate insurance authorization.How do I obtain prior authorization for Spravato?
To obtain prior authorization for Spravato, submit the required clinical documentation to the patient's insurance provider. This typically includes a detailed treatment plan and justification for the use of Spravato based on the patient's condition.What billing codes should I use for TMS services?
For TMS services, use the appropriate CPT codes, such as 90867 for initial TMS treatment and 90868 for subsequent sessions and 90869 for redetermination of the motor threshold. Verify with the insurance provider for any specific coding requirements.
Are there specific documentation requirements for TMS billing?
Yes, documentation must include the patient's diagnosis, treatment plan, progress notes, and any relevant assessments. This ensures compliance with insurance requirements and facilitates smoother billing.What are the common challenges in billing for Spravato?
Common challenges in billing for Spravato include obtaining prior authorization, ensuring proper documentation, and navigating insurance coverage limitations. Familiarize yourself with the specific requirements of each insurance network..
How can I streamline the patient intake process?
Streamlining the patient intake process can be achieved by utilizing electronic health records (EHR) systems, pre-screening questionnaires, and ensuring clear communication with patients regarding required documentation.
The patient should complete a Intake Packet as it relates to TMS or SPRAVATO® intake - this will help with facilitating the prior authorization for these treatments.
What should I include in the treatment plan for TMS?
The treatment plan for TMS should include the patient's diagnosis, treatment goals, frequency of sessions, and any adjunctive therapies. Additionally, the goal should be to reduce depression screening scores by a minimum of 50% and to assist the patient with symptom reduction. This plan is crucial for both clinical and billing purposes.
How do I handle denied claims for TMS or SPRAVATO®?
If a claim for TMS or SPRAVATO® is denied, review the denial reason, gather necessary documentation, and submit an appeal if warranted. Understanding the insurance policies can help prevent future denials, but most importantly, understanding the reason for the denial prior to submitting an appeal is critical. Many claims are denied for erroneous reasons - so the goal is to identify the actual reason for the denial.
What resources are available for training on TMS and SPRAVATO®?
MNH offers specialized, comprehensive training programs designed to improve operational efficiency, documentation compliance, and reimbursement success for TMS and SPRAVATO® clinics and psychiatry practices.
Available Training Courses:
-TMS Start It Up! Training
-Patient Intake & Prior Authorization Training
Each virtual course is delivered over two days and spans approximately 7–8 hours, allowing for in-depth instruction and real-world application.
The TMS Start It Up! Training course focuses on TMS documentation requirements, approved and covered TMS treatment protocols, and the critical roles and responsibilities of the TMS Technician — including how technician accuracy directly impacts insurance reimbursement, claim approvals, and overall revenue cycle performance. This course also addresses key operational strategies that support successful patient intake and payment outcomes.
The Patient Intake & Prior Authorization Training course provides a complete framework for managing the patient intake process, including accurate benefits and eligibility verification, payer-specific requirements, prior authorization submission, and documentation workflows that support faster approvals and reduced claim denials.
How can I ensure compliance with insurance requirements?
To ensure full compliance with insurance requirements for TMS and SPRAVATO® services, it is essential to stay current with evolving payer medical guidelines and coverage policies, maintain precise and compliant clinical documentation, and maintain ongoing communication with insurance representatives regarding policy updates, authorization changes, and reimbursement criteria.
Get Started with Metro NeuroHealth
Contact us today to learn how we can assist you in establishing your practice and navigating the complexities of TMS and psychiatry services.
OUR PROMISE
We are part of your team.
Experts in TMS therapy & Psychiatry Billing Services at a fraction of the cost of others.
Save Time & Money
Save time and money with improved collections for a fraction of the average price of billing. We keep our rates low, but make no mistake, our service and expertise is one of the best in the industry.
Friendly Support
Our support team is available everyday to ensure that things runs smoothly. You’ll always find the help you need, even after hours if needed - because your our client and that means something to us.
Comprehensive Reports
You’ll find it easy to monitor your billing, run your own reports at your leisure, and delight with peace in mind that your billing is being cared as it you were doing it yourself.
Complete A/R Management & Electronic Filing
Watch your profits increase and your value rise as you boost your company efficiency. It’s easier than you think. We guarantee you won't be disappointed.
