Condition Guide
High Denial Risk · ICD-10: F32
Depression Insurance Claim Denied?
Mental health treatment for depression including therapy and psychiatric medication management is frequently subject to prior authorization, visit limits, and medical necessity disputes. MHPAEA requires parity with medical benefits.
Why Depression Claims Are Denied
These are the most common denial reasons for Depression treatment claims.
Appeal Strategies for Depression
- 1Invoke MHPAEA: treatment limits for depression cannot exceed limits for analogous medical conditions
- 2Request a parity analysis — document how the insurer applies criteria differently to mental vs medical claims
- 3Provide GAF (Global Assessment of Functioning) scores and PHQ-9 depression severity scores
- 4For TMS therapy denial, cite FDA approval and clinical guidelines from APA
Insurer-Specific Guides
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