Psychotherapy services continue to be a major focus in behavioral health audits, payer reviews, and documentation denials. In this episode of Auditing Antics, we break down psychotherapy billing from an auditor’s perspective, including what documentation actually supports the service billed, how time based services are reviewed, and the common red flags that trigger denials and compliance concerns. We will discuss medical necessity, psychotherapy time requirements, add on codes, and the difference between psychotherapy documentation and E/M documentation. We also explore the growing conversation around whether practices should continue billing insurance or consider developing self pay models due to increasing audit pressure, reimbursement challenges, and administrative burden. Whether you are a provider, coder, auditor, or compliance professional, this episode focuses on the real world risks practices are facing and the steps that can help support cleaner claims, stronger documentation, and more sustainable practice operations.