For decades, diagnosing mental health conditions has relied largely on patient interviews, clinical observation, and standardized assessments. But that could be changing — fast.
Recent advancements in neuroscience and biomarker research are opening the door to a new possibility: using blood tests to support the diagnosis and treatment of mental health disorders. It’s a development that could bring objectivity, speed, and precision to what has historically been a subjective science.
As a medical billing company specializing in behavioral and mental health, we’re watching these breakthroughs closely — because what happens in the lab eventually affects your claims, your coding, and your revenue cycle.
Let’s dive into what’s emerging and how behavioral health practices should begin preparing.
Researchers are identifying blood-based biomarkers — such as certain proteins, inflammatory markers, and hormone levels — that correlate with mental health conditions like:
Major depressive disorder
Bipolar disorder
Schizophrenia
PTSD
Anxiety disorders
In 2021, a study published in Molecular Psychiatry found that a specific panel of blood markers could help distinguish between depression and bipolar disorder — two conditions that are often misdiagnosed due to overlapping symptoms.
These tests are still in the early stages of clinical adoption, but they represent a promising future where diagnostic decisions are supported not just by symptoms, but by science-backed data.
For psychiatrists and other mental health professionals, biomarker testing could provide a more nuanced picture of patient health — and a new layer of insight for developing personalized treatment plans.
That said, incorporating diagnostic blood testing into a behavioral health practice is not without its complexities.
Here’s what we recommend behavioral health providers keep in mind:
Know What’s Covered (and What’s Not): At present, many mental health-related blood tests are not yet covered by insurance. Some may be considered “experimental” or “investigational.” Always verify payer policies before ordering or billing.
Use Proper CPT and ICD-10 Codes: If and when coverage applies, it’s critical to select the appropriate CPT codes for lab tests and pair them with the correct diagnostic codes to demonstrate medical necessity.
Collaborate with Labs: Consider partnering with third-party labs that specialize in psychiatric biomarkers. Many offer billing support or pass-through models where the lab bills directly.
Document Thoroughly: As always, clear documentation of medical necessity is key. Be sure to note why the test was ordered, how it fits into the treatment plan, and any outcomes from prior treatments that justify a more advanced diagnostic approach.
Prepare for a Cash-Pay Component: Until broader insurance adoption takes place, some of these tests may require patient self-pay. Be transparent with patients and include the cost discussion as part of your intake or treatment planning process.
We’re likely still a few years away from biomarker blood testing becoming a routine part of mental health care, but the shift is underway. Forward-thinking providers who stay informed — and start preparing now — will be better positioned to adopt new tools when the time is right.
And when that happens, we’ll be ready to help you navigate the billing and coding changes that come with it.
Need support navigating billing for innovative mental health services? We’re here to help. Contact us today for a free consultation.