Prior-auth, coding and medical-necessity rules for 150+ payers
4.8(6)3HealthProductivity
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.
AI video with native sound, paid per clip. Nothing stored.
A calmer Mac menu bar, one click away.
Enterprise Software. Intelligent Automation. Global Impact.
Comments
3We run a billing company that only does behavioral health, and the single biggest time sink was looking up what each payer actually requires before a claim goes out: prior auth or not, which codes, what documentation, what changed and when. So we compiled the published policies from 150+ payers into one searchable, date-aware lookup and made it free with no login. If you bill for therapists, psychiatrists, ABA or treatment programs, we would love to hear which payer or rule you want added next.
Founder at Neuvon Intelligence | Building AI-powered products
its very helpful and good product and also working on my project
Building PZERO, saving you money - pzero.studio
Filtering 150+ commercial, Medicaid, and Medicare Advantage payers by CPT, ICD-10, date of service, and state for prior-auth and medical-necessity rules cuts the claim lookup grind for behavioral-health billers. If model bills start adding up, pzero.studio is where we buy leftover capacity.