Solutions
Our SUD billing specialists help treatment centers submit compliant claims, navigate complex reimbursement rules, and strengthen their revenue cycle.
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Every transition from detox to residential, PHP, IOP, outpatient, or MAT follows different authorization, documentation, and coding requirements. Missing a single step creates downstream reimbursement issues.
Commercial payers often apply stricter utilization management to behavioral health than to medical services. We identify parity opportunities and build stronger appeals in accordance with MHPAEA guidelines.
Medication-assisted treatment requires accurate documentation of HCPCS, CPT, and NDC administration and counseling. Even small coding errors can delay payment.
Our AAPC and AHIMA-certified coders specialize in substance use disorder billing, behavioral health coding, and payer-specific reimbursement policies across commercial, Medicare, and Medicaid plans.
OlympusAI continuously validates documentation, coding, authorizations, and payer edits before claims are submitted, improving billing accuracy and operational visibility.
From insurance verification through denial management and AR recovery, our SUD billing services support every stage of your revenue cycle without adding administrative burden.
OlympusAI combines specialty-trained AI agents with certified behavioral health billing experts to automate complex SUD billing workflows while maintaining human oversight.
Insurance eligibility, behavioral health carve-outs, authorization requirements, and covered services are validated before the first encounter.
Our billing specialists identify missing documentation and coding inconsistencies before claims leave your organization, reducing payer requests and rework.
Claims are scrubbed against payer edits, coding guidelines, authorization status, and documentation requirements before reaching the clearinghouse.
We verify benefits, obtain or monitor prior authorizations, and document payer-specific treatment requirements before services begin.
Certified coders apply accurate ICD-10-CM, CPT, HCPCS, modifiers, and MAT coding while maintaining compliance with current billing guidelines.
Our specialists manage underpayments, appeals, aging accounts receivable, and payer follow-up to improve cash flow and financial performance.
Our substance use disorder billing specialists support reimbursement for
Our certified billers and coders specialize in substance use and behavioral health billing, optimizing your entire revenue cycle management. We offer:
SUD billing involves managing claims for substance abuse treatment services including detoxification, inpatient treatment, intensive outpatient programs (IOP), medication-assisted treatment (MAT), counseling, and recovery support services. It requires specialized codes and understanding of addiction treatment billing.
Unique challenges include payer coverage restrictions on SUD services, documentation requirements for medical necessity, treatment frequency limitations, authorization tracking across multiple modalities, billing coordination between multiple treatment settings, and managing insurance denials based on coverage policies.
SUD codes include psychiatric evaluation codes, individual/group therapy codes, medication administration codes (for MAT), treatment planning codes, crisis intervention codes, recovery support codes, and may include medical evaluation/medication management codes depending on provider qualifications.
Plutus Health optimizes through proper code selection for services delivered, accurate session and duration tracking, comprehensive authorization management, proper documentation for treatment intensity, medication management billing when applicable, and effective denial appeals.
SUD programs using Plutus Health achieve clean claim rates of 97%+, better authorization hour utilization, reduced denials related to coverage and coding, faster reimbursement, improved documentation compliance, and optimized revenue from addiction treatment services.
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