Healthcare Insights
Where are behavioral health professionals providing care?
Behavioral health professionals work across multiple different care settings. From psychiatrists to psychologists to social workers, there are a variety of specialties helping patients improve their emotional, psychological, and social well-being at physical and virtual locations across the healthcare ecosystem.
While some settings, such as offices and outpatient hospitals, have long been the go-to for patients to receive treatment, others, such as telehealth, have grown rapidly as a way to better reach patients anywhere they may be. Now that behavioral health providers can practice telemedicine across state lines, patients in more remote areas have improved access to mental health care. This trend was advanced by the COVID-19 public health emergency, which allowed certain clinicians in good standing to practice teletherapy across state lines.
Using information from the Definitive Healthcare Atlas All-Payor Claims Dataset, we took a look at the types of settings and facilities in which behavioral health professionals are providing and billing care.
| Rank | Place of service code | Place of service | Percent of U.S. behavioral health claims in 2022 | Explore dataset |
|---|---|---|---|---|
| 1 | 11 | Office | 39.1% | Explore |
| 2 | 2 | Telehealth (provided other than in patient’s home) | 24.3% | Explore |
| 3 | 10 | Telehealth (provided in patient’s home) | 6.7% | Explore |
| 4 | 22 | On campus - outpatient hospital | 5.8% | Explore |
| 5 | 53 | Community mental health center | 3.9% | Explore |
| 6 | 21 | Inpatient hospital | 3.8% | Explore |
| 7 | 12 | Home | 2.8% | Explore |
| 8 | - | Code not listed | 2.8% | Explore |
| 9 | 99 | Other place of service | 2.6% | Explore |
| 10 | 50 | Federally qualified health center | 1.9% | Explore |
| 11 | 3 | School | 1.6% | Explore |
| 12 | 51 | Inpatient psychiatric facility | 1.3% | Explore |
| 13 | 57 | Non-residential substance abuse treatment facility | 1.0% | Explore |
| 14 | 32 | Nursing facility | 0.5% | Explore |
| 15 | 19 | Off campus - outpatient hospital | 0.5% | Explore |
Fig. 1. Data is from the Definitive Healthcare Atlas All-Payor Claims Dataset. The ranking is based on an analysis of behavioral health providers’ patient claims activity by setting of care for calendar year 2022. Claims data is sourced from multiple medical claims in the United States and is updated monthly. Accessed April 2023.
What types of care settings do behavioral health professionals work in?
At the top of the list sits office setting, where 39.1% of behavioral health claims were filed in 2022. This percentage is a three-point increase from 2021, and an 18 point decrease from the pre-pandemic year of 2019, when 56.7% of behavioral health encounters took place in an office setting.
In the past couple of years, telehealth has grown rapidly as a way for behavioral health professionals to provide their services. This growth is evident in our data, with 24.3% of behavioral health claims taking place in a virtual setting, represented by codes 02 and 10 in the table above.
The other one-third of behavioral health visits in 2022 took place in a variety of settings, from both outpatient and inpatient hospital settings, community mental health centers, to schools.
Where do behavioral health professionals bill care?
It’s also interesting to look at the types of organizations that bill for behavioral health claims to see which kinds of practices are delivering these vital healthcare services. This table shows the percentage of behavioral health claims filed in 2022 by type of billing organization.
| Rank | Facility type | % of U.S. behavioral health claims in 2022 | Explore dataset |
|---|---|---|---|
| 1 | Physician Group | 44.57% | Explore |
| 2 | No facility listed | 42.53% | Explore |
| 3 | Hospital | 9.30% | Explore |
| 4 | Federally Qualified Health Center | 2.58% | Explore |
| 5 | Home Health Agency | 0.39% | Explore |
| 6 | Rural Health Clinic | 0.23% | Explore |
| 7 | Assisted Living Facility | 0.15% | Explore |
| 8 | Imaging Center | 0.12% | Explore |
| 9 | Urgent Care Clinic | 0.04% | Explore |
| 10 | Skilled Nursing Facility | 0.03% | Explore |
| 11 | Specialty Pharmacy | 0.02% | Explore |
| 12 | Ambulatory Surgery Center | 0.02% | Explore |
| 13 | Hospice | 0.01% | Explore |
| 14 | Renal Dialysis Facility | 0.01% | Explore |
| 15 | Retail Clinic | 0.00% | Explore |
Fig. 2. Data is from the Definitive Healthcare Atlas All-Payor Claims Dataset. The ranking is based on an analysis of behavioral health providers’ patient claims activity by setting of care for calendar year 2022. Claims data is sourced from multiple medical claims in the United States and is updated monthly. Accessed April 2023.
Where are most behavioral health visits billed?
At 44.6%, a majority of behavioral health professionals bill care or submit claims through a physician group. Some of these physician groups consist of hundreds of behavioral health providers, while others consist of only one provider.
Right behind physician groups, we find that 42.5% of behavioral health professionals did not bill claims through any particular facility. This fact is not surprising, given the number of these clinicians that work in private practice, which would not show up as a facility type in our platform. Many of these professionals accept a limited number of insurance plans or simply don’t accept insurance at all. Those that don’t accept insurance would not be reflected in the above percentages.
To round out the top five, 9.3% of behavioral health professionals billed work through a hospital, 2.6% at a federally qualified health center, and 0.4% at a home health agency.
What are some of the limitations of behavioral health providers working in a private practice?
With many behavioral health professionals stepping out on their own and managing their own independent practices, there come some billing limitations, especially as it relates to insurance.
Low reimbursement rates from insurers, coupled with the hassles of interacting with them, discourage behavioral health professionals from wanting to work with them in the first place. With demand for mental health treatment remaining high, many behavioral health professionals, especially those that are highly sought after, have a low incentive to accept insurance.
Given the high demand for behavioral health services, providers are able to find enough patients willing to pay out-of-pocket for these highly valued services. Fortunately, an increase in telehealth services is allowing some of these providers to keep costs down and offer therapy at a lower price.
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