Mental health billing in Alberta is underutilized by GPs and often misapplied by psychiatrists. SOMB provides dedicated codes for mental health management visits, psychotherapy, and psychiatric consultations — but the eligibility rules are specific.
This page covers the main mental health billing pathways in Alberta SOMB, including what each code requires and where physicians commonly leave money on the table.
| Billing Pathway | Who Can Bill | Key Requirement |
|---|---|---|
| Mental health visit (GP) | General practitioners | Primary focus of encounter is mental health assessment or management |
| Psychiatric consultation | Psychiatrists | Referred by another physician; full psychiatric assessment documented |
| Psychotherapy (individual) | Physicians credentialed for psychotherapy | Time-based; requires formal psychotherapy training and documentation |
| Crisis intervention | GPs and psychiatrists | Acute psychiatric emergency requiring immediate intervention |
| Subsequent psychiatric visit | Psychiatrists | Follow-up after initial consultation; complexity and duration matter |
Alberta SOMB includes specific mental health management visit codes for GPs that pay at a higher rate than a standard office visit when the primary reason for the encounter is a mental health condition. To bill this code correctly:
Psychiatrists billing SOMB consultations follow the standard Alberta consultation framework — which requires a formal referral, a complete assessment, and a written report back to the referring physician. Key points:
Physicians who are formally credentialed in psychotherapy can bill psychotherapy codes under SOMB. This is time-based billing — the session length must meet the minimum threshold for the code. Key requirements:
GPs often see a patient presenting with depression or anxiety and bill a standard office visit. If the primary issue is mental health and the encounter involves a proper mental health assessment, the mental health visit code applies and pays more. This is the most common missed opportunity.
Not all physicians can bill SOMB psychotherapy codes. Billing these codes without CPSA-recognized psychotherapy training is a billing error that creates audit risk. Supportive counselling is not billable as psychotherapy.
Psychiatrists sometimes bill subsequent visits as consultations. After the initial consultation, follow-up visits should be billed as subsequent psychiatric visits — not as new consultations — unless there is a new clinical question from the referring physician.
When a patient presents in acute psychiatric crisis requiring urgent assessment and management — including risk assessment and safety planning — a crisis intervention code may be applicable. Many physicians bill this as a standard visit, underbilling for the clinical complexity involved.