Behavioral Health Payer Policies Tool

The Behavioral Health Payer Policies Tool is a free, no-login database of the rules payers actually apply to mental health and substance-use claims. Filter by payer, date of service, CPT code, ICD-10 diagnosis, payer class and state to see prior-authorization requirements, covered codes, documentation and medical-necessity criteria, telehealth and modifier rules, and common denial reasons.

Coverage spans 150+ commercial, Medicaid managed-care and Medicare Advantage payers including subsidiary plans, compiled from each payer's published medical policies, coverage bulletins and provider manuals and refreshed as policies change. Built for therapists, psychologists, psychiatrists, PMHNPs, ABA providers, treatment programs, billers and coders. Publisher: Ardent Practice Partners, a behavioral-health-only billing company. The tool can also be embedded on any website free of charge.