Behavioral Health Billing Companies (2026): 10 Firms Compared for Practices and SUD Programs

The right behavioral health billing company is one that already bills your levels of care, in your state, for payers like yours. For SUD treatment centers running detox, residential, PHP and IOP programs, Coronis Health, Prosperity Behavioral Health, Integrity Billing Company and Revenue Logic describe billing, utilization review and authorization work built for those programs. Solo and group therapy practices can look at TheraThink and MedCare MSO, and organizations already on Qualifacts, Netsmart or Valant can hire those vendors' own RCM teams. Programs that would rather automate billing work inside their current systems than hand it to a firm can consider Adentris.

Whether to outsource at all is a separate decision about cost shape, control and volume, and we cover it in In-House vs. Outsourced RCM for Behavioral Health: The 2026 Math. This guide assumes you are hiring a firm or replacing one, and it is about choosing well.

Below are 10 options, described from their own websites as of October 2026 and not ranked, followed by the questions, fee models, contract terms, reports and red flags to check before you sign.

How we chose

Every firm here states a behavioral health, mental health or SUD focus on its own website and describes billing performed as a service, not only software. We confirmed services, who each firm serves and any stated scope on its own pages, cited in Sources. Three EHR vendors are included because their sites describe RCM teams that do the billing for clients; software-only platforms are covered in our behavioral health billing software comparison. Firms we could not verify were dropped.

Behavioral health billing companies at a glance

Services and pricing change, so confirm details with each firm.

1. Coronis Health

What it is: A specialty revenue cycle company that lists behavioral health among ten specialties and says it manages more than $20 billion in collections a year. Its behavioral health service runs from patient access to back-end recovery.

Best for: Behavioral health facilities and larger groups that want one firm to run the whole cycle, from enrollment to legacy A/R.

Strengths:

• Eligibility, prior authorization and a contact center, plus provider enrollment, credentialing and contract support
• Coders trained in level-of-care documentation and utilization review requirements, plus CDI, coding audits and clinical validation
• Denial root cause analysis, clinical appeals and underpayment recovery

Watch-outs:

• Behavioral health is one specialty among many; ask who would staff your account.
• Pricing is not published.

2. Prosperity Behavioral Health

What it is: A revenue cycle firm whose team, it says, works only on behavioral health billing, with services for SUD treatment centers and for outpatient mental health, psychiatry and group practices.

Best for: SUD treatment centers with detox, residential, PHP, IOP and MAT services.

Strengths:

• Manages prior authorizations and continued-stay reviews for detox, residential and intensive programs
• Per diem and service-specific claims, CPT, HCPCS and ICD-10 coding, and daily submission and payment posting
• Dashboards for claims, denials, A/R aging and program-level performance, plus credentialing and contracting

Watch-outs:

• It says it can integrate with major behavioral health platforms "in most cases"; confirm yours.
• Pricing depends on program size, census and service mix; request a written quote.

3. Integrity Billing Company

What it is: A billing and revenue cycle firm focused on substance abuse and behavioral health facilities, serving addiction treatment, residential and outpatient centers.

Best for: Addiction treatment centers that want billing and utilization review from one vendor.

Strengths:

• Utilization review covering initial, concurrent and retrospective reviews, with appeals of denials
• i-bot, a proprietary verification of benefits portal for admissions teams
• Billing and coding, collections, denial management, contracting and credentialing, and aging reports

Watch-outs:

• Built around facilities; outpatient therapy practices should confirm fit.
• Performance figures on its site are self-reported; ask for references at your level of care.

4. Adentris

Disclosure: Adentris publishes this guide.

What it is: Automation instead of outsourcing. Adentris is an AI platform that runs the billing and coding workflow inside the systems you already use, so your EHR and billing system stay the system of record. It connects to the EHR through its API or FHIR, HL7 feeds, an API our agents build where none exists, or the AI Web Agent, usually with no IT project on your side, and it is typically live in about 30 days. It codes every claim against the chart, checks claims and charts before submission, builds prior authorization packets, and works denials with rule-cited appeals.

Best for: BH and SUD programs, and other providers, that want billing, coding and denial work automated without handing it to an outside team or replacing their systems.

Strengths:

• Reviews every active chart, not a sample, against ASAM level of care, medical necessity, 42 CFR Part 2, Medicaid and payer documentation rules, and treatment plan and signature timing; each finding cites the rule that fired, with a drafted correction for staff to approve
• Prior authorization packets built from the chart and submitted across portal, fax and phone, with every window tracked, including peer-to-peer
• SOC 2 Type I and Type II, a signed BAA, and AI inference inside Microsoft Azure with no patient data sent to external LLM APIs

Watch-outs:

• Not a staffing firm: your team approves corrections and remains accountable for the billing operation.
• You keep your own EHR and billing system, so Adentris does not replace one that cannot bill your levels of care. Deepest in BH and SUD rules; other specialties should confirm coverage.

5. Revenue Logic

What it is: A behavioral health only revenue cycle firm serving addiction treatment centers, mental health providers and dual-diagnosis programs across detox, residential, PHP, IOP, outpatient and MAT.

Best for: Treatment centers with significant out-of-network or repriced claims that want close utilization review support.

Strengths:

• Benefit verifications returned within two hours plus payer hold time, with PayerLenz, its benchmark of expected out-of-network reimbursement
• Utilization review grounded in ASAM and LOCUS, including peer-to-peer preparation
• Weekly claim submission, bi-weekly follow-up on open claims, and pushback on TPA and repricing offers

Watch-outs:

• It says PayerLenz helps most for out-of-network providers; Medicaid-heavy programs should ask how many clients look like them.
• It says it does not compete on price, and pricing is not published.

6. Qualifacts (RCM services)

What it is: The RCM services arm of the behavioral health EHR company, offered as a co-sourced partnership in which its billing team works inside your Qualifacts EHR as an extension of your staff.

Best for: Community behavioral health agencies on a Qualifacts EHR that want to keep some billing staff and add capacity.

Strengths:

• More than 200 billing experts, by its count, working in the same system your team uses
• Ongoing payer rule updates, credentialing support and billing audits
• Designed to absorb growth in programs, payers or locations without new billing hires

Watch-outs:

• The service is described as delivered within a Qualifacts EHR.
• Co-sourcing splits the work; define in writing which tasks stay with your staff.

7. Netsmart (RCM services)

What it is: The RCM services team of the human services and post-acute EHR company, which offers a full or partial billing outsource alongside its revenue cycle software.

Best for: Larger human services organizations, including addiction treatment programs, that want to outsource specific functions or the whole back office.

Strengths:

• Pre-service support for eligibility, prior authorizations and provider enrollment, plus coding services
• A/R management, cash posting and A/R reduction projects aimed at denial root causes
• Utilization management services, and collection automation (AlphaCollector) that it says is EHR-agnostic

Watch-outs:

• Some AI-assisted functions are marked on its site as under development; confirm what is live.
• Its scope spans many care settings; ask how many behavioral health clients the services team supports.

8. Valant (RCM services)

What it is: A dedicated billing team from the behavioral health EHR company that works directly within the Valant EHR, so documentation, coding and billing run in one system.

Best for: Outpatient practices, growing groups and IOP or PHP programs on Valant.

Strengths:

• Billing specialists review and submit claims and monitor claim status through the clearinghouse
• Denial review, appeals, insurance and patient payment posting, EFT setup and patient statements
• A/R reporting inside the same EHR your clinicians use

Watch-outs:

• The service assumes you are on the Valant EHR.
• Credentialing is not among the RCM services on that page, so ask if you need it.

9. MedCare MSO

What it is: A multi-specialty billing company with mental health and substance abuse billing services for therapists, psychologists, psychiatrists, behavioral health clinics and treatment centers.

Best for: Psychiatry and therapy practices, and outpatient programs that want credentialing and billing from one firm.

Strengths:

• Full-cycle billing with AAPC- and AHIMA-certified coders, including IOP and PHP HCPCS and revenue codes
• Credentialing, CAQH and re-credentialing management, plus compliance reviews
• Pricing stated as a percentage of collections with no setup fees, and integration with your existing EHR

Watch-outs:

• Behavioral health is one of many specialties; ask for references at your level of care.
• It also sells its own EHR and AI tools; buy billing services on their own merits.

10. TheraThink

What it is: A mental health insurance billing service for therapists and psychiatrists, based in Seattle and billing since 2014.

Best for: Solo clinicians and small group practices that want simple, published pricing.

Strengths:

• A published fee of 6.5% to 8% of the allowed amount on claims it helps collect, with no startup or per-claim fees
• Free eligibility and benefits checks, EAP, Medicare, Medicaid, TRICARE and out-of-network billing
• Month-to-month contract, a named admin contact, and credentialing at a fixed rate per application

Watch-outs:

• Claims go out through its own system, so appointments must be entered there or sent to its team.
• A clearinghouse fee of $35 per month per tax ID and rendering NPI combination can apply.

How to evaluate a behavioral health billing company

Behavioral health and SUD expertise checks

Every firm says it knows behavioral health. These checks show whether it does:

• Levels of care billed today. Ask which of detox, residential, PHP, IOP, outpatient and MAT they bill now, on which claim types, and in which states.
• Utilization review. Ask who runs initial and concurrent reviews and peer-to-peer calls, and whether those people work from ASAM or LOCUS criteria.
• Group and per diem billing. Have them walk one group session and one residential week from attendance record to claim.
• 42 CFR Part 2. Part 2 lists bill collecting among the services a qualified service organization provides, so a Part 2 program should have a QSO agreement in place before records move. See our Part 2 consent guide.
• Documentation gaps. Ask what happens when a note does not support a code. OIG's guidance for billing companies says they should get clarification from the provider; a good answer sends gaps back to clinicians.

Questions to ask in every sales call

1. Who works our account, where, and is any work subcontracted or offshore?
2. Do you work in our EHR and billing system or yours, and who owns the clearinghouse, ERA and payer portal enrollments?
3. When is a denial first touched, how far do appeals go, and who approves write-offs?
4. How do you handle payer audits, records requests and overpayments?
5. Will you send us your compliance program? OIG says billing companies should, at a minimum, send it to every provider client.
6. Do you screen staff against OIG's List of Excluded Individuals/Entities, and how often?
7. Can we speak with two clients at our level of care and payer mix?

Reporting to require

A report that only shows collections tells you little. Require denials by reason code and payer, A/R aging by payer and program, authorization status for higher levels of care, underpayments against contracted rates, write-offs with reasons, and credit balances, plus each metric's written definition and exportable claim-level data so you can check the summary yourself.

Credentialing and enrollment

Settle who maintains CAQH profiles, files payer applications and tracks revalidation, and whether those records stay yours at exit. MedCare MSO's site says credentialing takes 90 to 120 days, during which you cannot bill in-network payers, so start early. For Medicare, the CMS-855I enrollment form has a billing agency section you must complete if you use one, and it states that you remain responsible for the accuracy of claims submitted on your behalf.

Fee models compared

The base matters as much as the rate. In TheraThink's own example, a session billed at $150 where insurance pays $50 and the patient owes $10 has a $60 allowed amount. As a hypothetical comparison, 8% of the allowed amount is $4.80, while 8% of insurance payments alone would be $4.00. Across thousands of claims, the definition decides the bill.

Percentage fees also interact with federal payment rules. Medicare may pay a billing agent only if the agent's compensation is not related to the amounts billed or collected (42 CFR 424.73), and Medicaid has a parallel rule for business agents (42 CFR 447.10). The CMS claims processing manual says those conditions do not apply when the agent only prepares bills and does not receive the payments, which is why payments should land in the provider's own account. OIG also has a "longstanding concern" that percentage arrangements may increase the risk of upcoding, so ask how the firm's coders are paid and audited. This is general information, not legal advice; have counsel review any billing contract.

Contract terms to get in writing

• Payment flow. Payer deposits land in an account in your name that only you control.
• Fee definitions. What counts as a collection, and whether fees are refunded when a payer recoups.
• Term and exit. Notice period, no penalty for termination with cause, and who works claims in flight afterward. Medicare claims must be filed within one calendar year of the date of service (42 CFR 424.44), so a messy handoff costs money.
• Data return. HIPAA requires the business associate agreement to provide for returning or destroying PHI at termination where feasible (45 CFR 164.504(e)). Add claim history, reports and payer correspondence in a usable format.
• Subcontractors. The BAA must require subcontractors to accept the same restrictions; ask for the list and where the work happens.
• Part 2. For Part 2 programs, a qualified service organization agreement, or a business associate agreement that meets the Part 2 definition.
• Service levels. Days from service to claim, denial follow-up cadence, report delivery dates, and audit support.

Red flags

• No references at your level of care, or only references from other specialties.
• Payments routed to the firm's account while it charges a percentage.
• Guaranteed revenue increases, or coding advice that always moves to the higher-paying code.
• Reports limited to collections, with no denial detail by reason code and payer.
• Payer portals, clearinghouse enrollment or data held in the firm's name with no exit plan.
• Denials written off without your approval, or appeals that stop after the first level.
• No written compliance program, no exclusion screening, or reluctance to sign a BAA.
• Pressure on clinicians to rewrite past notes to fit a code instead of using a documented addendum process.

One more reality check: a billing company works the claim, but many behavioral health denials are decided in the chart. A firm can appeal faster; it cannot add medical necessity that was never documented.

How Adentris helps

If you are shopping for a billing company because collections slipped, find out where the revenue is going first. Our AR audit and RCM insights review looks at claims, denials, EOBs and chart evidence together and delivers first findings in 3 days, so you can see whether the gap is in billing follow-up, documentation, or both, and you get a baseline to hold any vendor to.

If you would rather automate than outsource, Adentris runs the billing and coding workflow inside your EHR and billing system: it codes every claim against the chart, checks claims and charts before submission, builds prior authorization packets, and works denials with rule-cited appeals. At Resilient Recovery Treatment, a multi-site SUD network in Los Angeles, documentation accuracy rose from 73% to 96% in 90 days, denials fell 62%, and ROI reached 7.6x in 4 months. To see it on your own charts, book a 30-minute call with our team.

Related reading

• In-House vs. Outsourced RCM for Behavioral Health: The 2026 Math
• Denial Codes in Behavioral Health: The CARCs That Cost BH and SUD Programs the Most
• Medicare and Medicaid Audits in Behavioral Health: RAC, UPIC, TPE, SMRC and MFCU Explained

Sources

• Coronis Health: Behavioral health billing and RCM; Homepage
• Prosperity Behavioral Health: Rehab medical billing services; Behavioral health billing services
• Integrity Billing Company: Homepage; Utilization review services
• Revenue Logic: Homepage; About
• Qualifacts: Revenue cycle management services
• Netsmart: Revenue cycle management
• Valant: Revenue cycle management
• MedCare MSO: Mental health billing services; Substance abuse billing services
• TheraThink: Pricing; FAQ
• eCFR: 42 CFR 424.73; 42 CFR 447.10; 42 CFR 424.44; 45 CFR 164.504; 42 CFR 2.11
• CMS: Medicare Claims Processing Manual, Chapter 1, section 30.2.4; CMS-855I enrollment application, Section 8
• HHS-OIG: Compliance Program Guidance for Third-Party Medical Billing Companies (63 FR 70138); List of Excluded Individuals/Entities

Product names and logos are trademarks of their respective owners. Descriptions are based on each vendor's public website as of October 2026.

Frequently asked questions

What is the best behavioral health billing company?

The one that already bills your levels of care and payer mix. SUD treatment centers often look at Prosperity Behavioral Health, Integrity Billing Company, Revenue Logic or Coronis Health; therapy practices at TheraThink or MedCare MSO; and organizations on Qualifacts, Netsmart or Valant at those vendors' RCM teams.

How much do mental health billing services cost?

Pricing models vary. TheraThink publishes 6.5% to 8% of the allowed amount, MedCare MSO states a percentage of collections with no setup fees, and Prosperity prices by program size, census and service mix. Get every quote in writing on the same base, including add-on fees.

Can a billing company charge a percentage for Medicare and Medicaid claims?

Medicare and Medicaid will not pay a billing agent whose compensation is tied to amounts billed or collected. CMS says those conditions do not apply when the agent only prepares bills and does not receive the payments, so keep deposits in your own account and have counsel review the contract.

Does a billing company need a BAA or a QSOA?

A billing company handling PHI for a covered entity is a business associate and needs a BAA. Part 2 programs typically add a qualified service organization agreement; a business associate of a Part 2 program that is also a covered entity can qualify as a QSO for records that are also PHI.

Am I still responsible for claims my billing company submits?

Yes. The CMS-855I enrollment form states that even if you use a billing agency, you remain responsible for the accuracy of claims submitted on your behalf.

What should I ask before hiring a behavioral health billing company?

Which levels of care and states it bills today, who runs utilization review, where the work is done, who owns payer and clearinghouse enrollments, how denials are worked and written off, what reports you get, and how you exit with your data.