Licensed therapist in private practice reviewing Medicare billing documentation
Medicare Billing Alert — New 2024 Rules

Your Medicare Claims Are
Already Being Audited

LCSWs, LMFTs, and LPCs became Medicare-eligible in January 2024. Thousands of therapists are now billing Medicare for the first time — and making costly documentation errors that trigger audits and overpayment demands.

Get Monthly Compliance Intelligence $197/month · Cancel anytime · First report in 48 hours
Active OIG priority: Medicare mental health billing by newly eligible independent therapists is a flagged audit target for 2025–2026. Documentation errors average $12,400 in overpayment demands per audit.
Therapist in private practice office reviewing mental health billing compliance

Built for the Therapist in Private Practice

LCSW LMFT LPC LCPC LMHC
Coverage

Every CPT Code You Bill — Monitored Monthly

We track CMS policy updates, LCD changes, and OIG enforcement actions for the exact codes independent mental health therapists use.

90837
Psychotherapy, 60 min
Your highest-volume code and the most scrutinized. Medicare requires specific documentation of medical necessity, treatment goals, and session progress.
High Audit Risk
90834
Psychotherapy, 45 min
Time-based code requiring documented start/stop times. Frequently downcoded by Medicare contractors when documentation is insufficient.
High Audit Risk
90832
Psychotherapy, 30 min
30-minute psychotherapy. CMS monitors billing patterns — unusually high or low frequency relative to your patient population triggers review.
Pattern Monitored
90791
Psychiatric Diagnostic Eval
Initial evaluation code. Medicare allows once per episode of care — rebilling raises flags. Documentation must justify the need for evaluation.
Frequency Flag
90847
Family Psychotherapy (w/ Patient)
Reimbursement and documentation requirements changed in 2024. Place of service rules for telehealth add another layer of complexity.
2024 Policy Change
90846
Family Psychotherapy (w/o Patient)
Medicare coverage for family therapy without the patient present has specific medical necessity criteria that differ from commercial payers.
New Eligibility Rules
Your Monthly Report

What Arrives in Your Inbox Every Month

A plain-English compliance intelligence briefing written for the solo therapist, not a billing department.

📋
CPT Code Updates
Any changes to coverage, reimbursement rates, or documentation requirements for your specific codes — with plain-English explanation of what it means for your practice.
🔒
Medical Necessity Standards
Current Medicare documentation requirements for mental health services, including what your session notes must contain to survive an audit review.
💻
Telehealth Billing Rules
Post-PHE telehealth rules for mental health services are complex and still evolving. We track every CMS update and translate it into clear billing guidance.
🚨
OIG Enforcement Alerts
When the OIG publishes audit findings or RAC contractors issue new targeting criteria for mental health billing, you'll know before your next claim goes out.
🏥
Carrier Policy Changes
Medicare Advantage plan requirements differ from Original Medicare. We track your specific carriers and flag when their mental health billing policies change.
One Action Item Per Report
Every report ends with the single most important thing you should do in the next 30 days to reduce your compliance risk. No overwhelm. Just clarity.
Process

How It Works

1
Subscribe & Complete Intake
Tell us your state, credentials, and which carriers you're credentialed with. Takes 3 minutes.
2
First Report in 48 Hours
Your personalized compliance snapshot lands in your inbox — current rules, your codes, your carriers.
3
Monthly Intelligence Digest
On the 1st of each month, a new report covers anything that changed in the prior 30 days.
4
Stay Ahead of Audits
Know the rules before the auditor does. Adjust documentation proactively, not in response to a demand letter.
Healthcare insurance billing paperwork for mental health practice

Your Specific Carriers. Not Generic Advice.

Tell us which payers you're credentialed with and we monitor those carriers specifically — not a generic national overview.

Medicare Part B
Medicare Advantage
UnitedHealth / Optum
Aetna
Cigna / Evernorth
BCBS
Tricare
Medicaid (state-specific)
Pricing

Simple, Transparent Pricing

One plan. Everything included. Cancel any month.

Practice Compliance Monitor

Monthly intelligence for solo & small-group practices
$ 197 /month
Everything Included
  • Monthly CPT code update report for 90832, 90834, 90837, 90791, 90846/90847
  • Medicare medical necessity documentation standards — current requirements
  • Telehealth billing rules (post-PHE, place of service, audio-only coverage)
  • OIG enforcement alerts for mental health billing
  • Carrier-specific policy changes for your credentialed payers
  • Plain-English — no billing jargon, no legalese
  • One prioritized action item per report
  • First report delivered within 48 hours of signup
  • Cancel anytime — no contracts, no annual commitment
Subscribe Now — $197/month

Secure payment via Stripe · You'll be directed to complete your practice intake form after payment

From the Community

What Therapists Are Saying

★★★★★

"I enrolled in Medicare in March 2024 and immediately felt overwhelmed. The first report flagged two documentation issues in my session notes I didn't know about. Worth every penny."

Rachel M., LCSW
Private Practice · Portland, OR
★★★★★

"The telehealth billing section alone justified the subscription. I had no idea the post-PHE rules were still changing. My billing was technically incorrect for three months without realizing it."

David K., LMFT
Solo Practice · Nashville, TN
★★★★★

"As an LPC who just became Medicare-eligible, I had no idea how to stay current on compliance. This service gives me the confidence that I'm billing correctly every month."

Sandra T., LPC
Group Practice · Columbus, OH
FAQ

Common Questions

I'm not enrolled in Medicare yet. Is this still useful?

Yes — understanding the rules before you enroll is the best time to start. Many documentation habits are formed early and are hard to correct after an audit notice arrives. We can help you set up correctly from day one.

Is this legal advice or official compliance guidance?

No. This is compliance intelligence — we synthesize publicly available CMS policies, OIG guidance, and carrier documentation into plain-English summaries. We are not attorneys or billing compliance officers. For complex situations, consult a qualified healthcare compliance attorney.

Why did LCSWs and LMFTs only become Medicare-eligible in 2024?

The Consolidated Appropriations Act of 2023 expanded Medicare Part B coverage to Licensed Clinical Social Workers and Marriage and Family Therapists starting January 1, 2024. Tens of thousands of therapists are now billing Medicare for the first time with no prior compliance infrastructure.

How is this different from what my EHR or billing software provides?

EHR systems help you submit claims — they don't proactively monitor regulatory changes or flag compliance risks. This service specifically watches for policy updates and enforcement trends that affect how you should document and code your services.

What telehealth billing information do you cover?

We track post-PHE telehealth extension rules, place of service code requirements (POS 02 vs. POS 10), audio-only session coverage, patient location requirements, and any changes to Medicare's telehealth flexibilities as they are extended or modified by Congress and CMS.

Can I cancel anytime?

Yes, anytime. No annual contracts, no cancellation fees. Log in to your Stripe billing portal to cancel before your next billing date. You'll keep access through the end of your paid period.

Don't Let an Audit Find Your Documentation Gaps Before You Do

Every month you bill Medicare without current compliance intelligence is a month of potential exposure. Start monitoring today.

Subscribe Now — $197/month