Marsa Health field guides
Practical answers for payer work.
Source-backed checklists, templates, buyer guides, and operating playbooks for behavioral-health teams working prior authorizations, denials, benefits, credentialing, intake, and payer operations.
Behavioral Health Prior Authorization Checklist
A step-by-step prior auth checklist for behavioral health: lock the request, verify benefits and auth rules, map evidence to criteria, track the decision.
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behavioral health prior authorization checklist
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EAP Billing for Therapists: How It Differs From Insurance
EAP sessions are employer-funded, carry their own authorization, and are billed separately. How to verify, bill, count sessions, and hand off to insurance.
13 min read · Updated Jul 28, 2026
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Eating Disorder Concurrent Review: Defending Level of Care
Run eating disorder concurrent review in short authorization increments: multidisciplinary evidence, the step-down defense, and expedited appeals.
14 min read · Updated Jul 28, 2026
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Medicare 190-Day Rule for Inpatient Psychiatric Care
Medicare's 190-day lifetime limit applies to freestanding psychiatric hospitals, not general-hospital psych units. How to check days left before admission.
13 min read · Updated Jul 28, 2026
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Mobile Crisis and Stabilization Billing in Medicaid
How Medicaid pays for mobile crisis and stabilization services: the ARPA option, state code sets, what to capture during a response, and billing afterward.
13 min read · Updated Jul 28, 2026
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Collaborative Care Model (CoCM) Billing Requirements
How monthly CoCM billing works: 70- and 60-minute thresholds, consent, the registry, psychiatric consultation, and assembling each month's claim.
14 min read · Updated Jul 28, 2026
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Perinatal Mental Health Coverage: Postpartum Medicaid Guide
Most states extend Medicaid 12 months postpartum. How to verify perinatal coverage at intake and keep mental health treatment intact through plan changes.
13 min read · Updated Jul 28, 2026
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Incident-To Billing in Behavioral Health: Supervision Rules
Medicare now allows general supervision of behavioral health incident-to services and direct billing by MFTs and counselors. Map billing by payer.
14 min read · Updated Jul 28, 2026
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IMD Exclusion Explained: Medicaid's 16-Bed Rule and Waivers
Medicaid generally won't pay for adults 21–64 in IMDs over 16 beds. What counts as an IMD, and the waiver and managed-care pathways that fund care anyway.
13 min read · Updated Jul 28, 2026
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Measurement-Based Care Operations for Behavioral Health
Run measurement-based care as an operating system: instrument selection, administration cadence, score review, and using scores as authorization evidence.
14 min read · Updated Jul 28, 2026
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Deductible Reset in January: A Behavioral Health Playbook
Most deductibles reset January 1, shifting revenue to patient balances. The playbook: re-verification sweeps, early estimate talks, and cash-flow planning.
13 min read · Updated Jul 28, 2026
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Medicaid Managed Care Plan Changes: Provider Workflow
When a patient switches Medicaid plans, detect it fast, invoke transition-of-care protections, and move authorizations and claims to the new plan.
13 min read · Updated Jul 28, 2026
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Mental Health CPT Codes 2026: Common Codes and Payer Checks
2026 mental health CPT codes by family: 90791/90792, 90832–90838, 90846/90847, 90853, 90839/90840, and 90785, plus what to verify with each payer.
13 min read · Updated Jul 28, 2026
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IOP Billing Codes 2026: Payer Matrix and Authorization
Why IOP codes differ by payer and setting in 2026: revenue and condition fields, Medicare setting rules, authorization-to-claim checks, and a CSV matrix.
13 min read · Updated Jul 28, 2026
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PHP Billing Codes 2026: Payer Matrix and Claim Workflow
Partial hospitalization billing in 2026 by payer and setting: facility vs. professional services, certification, authorization, claims, and a CSV matrix.
13 min read · Updated Jul 28, 2026
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ABA CPT Codes 2026: 97151–97158 and Authorization Units
How ABA codes 97151–97158 map to authorizations, rendering roles, and units in 2026, how to reconcile units to claims, and how to prepare for 2027 changes.
13 min read · Updated Jul 28, 2026
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42 CFR Part 2 Consent Form Requirements: 2026 Checklist
What Part 2 consent forms need since the February 2026 compliance date: single TPO consent, patient notices, revocation, redisclosure, and a checklist.
14 min read · Updated Jul 28, 2026
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Medicare Behavioral Health Billing 2026: What to Verify
What changed in Medicare behavioral health billing for 2026 and what to verify: providers, settings, IOP, integration services, telehealth, and claims.
13 min read · Updated Jul 28, 2026
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Behavioral Health Billing Modifiers 2026: 59, 95, and 93
When to use modifier 59 or X{EPSU}, telehealth modifiers 95 and 93, and payer-specific modifiers in 2026, with same-day service controls and a CSV matrix.
12 min read · Updated Jul 28, 2026
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Substance Use Disorder (SUD) Billing Codes 2026
SUD billing by care pathway in 2026: Medicare OTP weekly bundles, office-based monthly bundles, counseling, IOP, residential, and a CSV pathway matrix.
13 min read · Updated Jul 28, 2026
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Residential Treatment Billing Codes 2026: Payer Matrix
Why no single code works for residential treatment billing: POS 55 vs. 56, per diem and bundled-day structures, authorized days, and a CSV payer matrix.
12 min read · Updated Jul 28, 2026
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SPRAVATO Billing Codes 2026: G2082, G2083, and Payer Rules
How to bill SPRAVATO (esketamine) in 2026: Medicare G2082 and G2083, payer-specific alternatives, REMS, drug and observation reconciliation, and a CSV log.
12 min read · Updated Jul 28, 2026
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TMS Billing Codes 2026: 90867, 90868, and 90869 Workflow
When to bill TMS CPT 90867, 90868, and 90869 in 2026, how to reconcile sessions to the authorization, and a CSV session ledger for claims and denials.
12 min read · Updated Jul 28, 2026
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Secure Insurance Card Capture for Behavioral Health Intake
A secure insurance card upload workflow for behavioral health: expiring links, file validation, front-and-back checks, identity matching, and retention.
12 min read · Updated Jul 28, 2026
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Abandoned Intake Recovery for Behavioral Health Admissions
Recover abandoned behavioral health intakes safely: resumable forms, consent-aware reminders, quiet hours, human takeover, and stale-record closure.
12 min read · Updated Jul 28, 2026
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