Best mental health billing companies for group practices (2026)

Where Cortexa fits

Cortexa is an operations team for independent therapy practices that runs the front desk, intake, billing, credentialing and payroll as one team. Billing runs about 3% of what you collect, and the front desk, intake and billing together about 6%. There's no long-term contract, and there's a 30-day money-back guarantee.

With Cortexa running billing, collections went from 82% to 97% of billed revenue. On $120,000 billed a month, 15 points is $18,000, three times a 6% fee on $100,000 collected. See whether it pays for itself with your numbers.

How to judge a mental health billing company

Judge a mental health billing company on six things before you sign. First, the fee and its basis. A percentage of the allowed amount, a percentage of collections and a flat monthly fee can produce very different invoices for the same month. Second, what's included. Some billing companies start when a claim is ready and stop at payment posting. Others also check benefits, collect patient balances or handle credentialing. Third, who does the work. Ask who works your account, whether you get a named contact, and how quickly they reply. Fourth, the contract. Look for the notice period, setup fees, minimums and what happens to open claims if you leave. Fifth, the business associate agreement. HHS lists claims processing and billing among the activities a business associate performs, so get a signed BAA before anyone sees client records. Sixth, claim status. You should be able to check the status of any claim yourself, without emailing someone and waiting.

Take this list of work to every sales call. Get a yes or no for each item, and the price if it costs extra.

• Eligibility and benefits checks at intake, before the first session
• Claim submission after each session
• Denial follow-up and appeals
• Patient statements and balance follow-up
• Credentialing for new clinicians, plus renewals
• Supervisory billing for pre-licensed clinicians
• Out-of-network claims and superbills
• A monthly accounts-receivable aging report

The fee basis changes what you pay

Two billing companies can quote similar percentages and send very different invoices, because they charge on different amounts. Some charge on the allowed amount, which is the insurer's payment plus what the client owes. Others charge on what's collected, and some charge per claim or a flat monthly fee.

In the example below, a session has a $120 allowed amount. The insurer pays $90. The client's $30 copay is never collected. The rates are round examples, not any company's price.

Mental health billing specialists

Mental health billing specialists take a claim from submission to payment, and most also check benefits and offer credentialing.

Choose this group when your front desk already collects accurate insurance details and you mainly need claims filed, denials worked and payments posted. Several of them quote group practices individually, so ask for group pricing in writing.

Flat-fee billing for solo and small practices

A flat monthly fee makes the billing invoice predictable, and these three companies publish theirs.

Flat fees suit a solo clinician or a small group with a steady insurance caseload. When collections are high, a flat fee can cost less than a percentage, but it stays the same in a slow month. Check what's excluded, how often claims go out and whether the company takes groups.

Billing through your EHR

Your EHR company may connect you with billing help, which keeps the claims inside the system your clinicians already use.

This route fits when you want one fewer system to manage. Ask who does the work, what it costs per claim or per month, and whether credentialing and patient balances are included.

Platforms that bill under their own arrangements

Alma and Grow Therapy do the insurance billing for clinicians who join them, under the platform's own insurance arrangements.

A platform and a billing company solve different problems. A platform like Alma or Grow gives a clinician access to its insurance contracts and rates, and it does the billing under them. A billing company works your practice's own contracts and bills in your practice's name. If you're a solo clinician without contracts, a platform can get you seeing insured clients quickly. If you're building a group, ask whose contracts your clinicians will bill under, what happens to those clients and rates if you leave, and whether your pre-licensed associates can join. Alma is open only to fully licensed clinicians. A group that hires associates and wants its own brand usually needs its own contracts, and then a billing company or operations team to work them.

Headway's pages didn't load when we checked on September 30, 2026, so our Headway and Alma guide covers Headway instead.

Many denials start at intake

Most billing companies begin once your practice has booked a client and sent the details, yet many denials trace back to what was captured at intake. Experian Health's 2025 State of Claims survey asked 250 healthcare professionals who make billing and claims decisions about denials. The top three causes were missing or inaccurate data (50%), authorizations (35%) and incomplete or inaccurate patient registration data (32%). That survey covers healthcare as a whole, but the pattern applies to a therapy practice too. A mistyped member ID shows up weeks later as a denial. So does a behavioral health plan run by a different company, or an out-of-network plan booked as in-network. A billing company can rebill or appeal that claim, but it can't go back and fix the intake call. With most billing services, your staff tell the biller about a new client and the biller checks benefits from there. TheraThink's FAQ describes this step. That handoff works well when your intake is accurate.

When one team runs both steps, the people who check eligibility at intake also file the claim after the session. A denial caused at registration comes back to them, so they can fix it at intake, where it started.

Cortexa, a full-service operations team

Each Full Service Partner membership is scoped to the practice and can include any of the work below.

At the front desk, we answer your practice's phone line, return voicemails and missed calls, and respond to email, website-form and directory inquiries, such as Psychology Today. We work from a written playbook of your services, clinicians, fees and policies, and the phone number stays yours. At intake, prospective clients see matched clinician options based on criteria your practice sets and approves, and the client chooses. We book the consultation and verify insurance eligibility and in-network status. For out-of-network and self-pay clients, we also calculate deductible status, coinsurance and estimated out-of-pocket cost.

For billing, we file claims after sessions, follow up on pending and denied claims, and pursue appeals where appropriate. The membership can include supervisory and incident-to billing under your payer contracts, out-of-network claims, superbills, patient statements and a monthly accounts-receivable aging report. You can check the status of any claim on your dashboard, any time. We manage credentialing at our actual documented cost. We run payroll on your existing payroll platform and calculate clinician pay from session-level data in your EHR.

We agree the exact scope and rate before you start, and you can start with only the work you need most. Practice Analytics is included, and we sign a BAA. You keep your brand, your own insurance contracts and your clients, and Cortexa doesn't bill under its own contracts.

Cortexa fits a group practice whose billing problems start at intake, that bills for supervised clinicians, or that pays clinicians by session. If your intake runs well and you only need claims filed, one of the billing specialists above is the simpler choice.

All options side by side

Prices are as each company publishes them. Confirm current terms in writing before you sign.