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Research · checked October 14, 2026

Behavioral health denial statistics 2026

Every figure on behavioral-health denials, prior authorization and appeals that we could trace to a primary source, each linked with its date. Vendor and association surveys are labelled, and the gaps are named.

By the ClaimParrot editorial team · Who we are · Reviewed · 8 min read · 18 cited sources

Quick answer

We found no neutral, nationally representative denial rate for behavioral health. The best anchors: HealthCare.gov insurers denied 19% of in-network claims in 2024 and fewer than 1% of denials were appealed (KFF). In New York, independent reviewers overturned about 61% of substance use and mental health denials that reached external appeal from 2019 to 2025 (JAMA Internal Medicine research letter).

Headline figures (open the linked source for definitions and caveats)
FigureValueSource and dateType
In-network claims denied, HealthCare.gov insurers, 202419% (insurer range 3% to 36%)KFF, Mar. 24, 2026Independent analysis of CMS data
Denied Marketplace claims that were appealed, 2024Fewer than 1%KFF, Mar. 24, 2026Independent analysis of CMS data
Standard prior-authorization requests denied, 2025Medicare Advantage 12%; Medicaid managed care 14%; Marketplace 18%KFF, Aug. 13, 2026Insurer-posted, regulator-required
NY external appeals overturned, 2019 to 2025Substance use 61.5%; mental health 60.6%; all 46.7%JAMA Intern Med, Apr. 13, 2026Peer-reviewed (figures via published coverage)
MA organizations requiring prior authorization for behavioral health8 of 9 reviewedGAO-25-107342, May 29, 2025Government audit
Sampled Philadelphia Medicaid BH prior-authorization denials meeting all requirements0 of 100HHS-OIG A-03-24-00204, June 2026Government audit
01

Is there a national denial rate for behavioral health?

No neutral, nationally representative one that we could find. Insurers' public reports do not break denials out by service type, and the new prior-authorization metrics are posted as plan-wide percentages. Behavioral-health denial rates of 15 to 20 percent, often repeated on vendor sites, have no traceable source.

KFF's analysis of 2024 Marketplace data notes that insurers do not report what types of services were denied; CMS collects medical-necessity denials reported separately for behavioral health but KFF does not publish that split, and separate behavioral-health claim reporting begins with plan year 2027 (KFF, Mar. 24, 2026). The prior-authorization metrics insurers began posting in 2026 likewise cannot be broken down by service (KFF, Aug. 13, 2026).

What does exist are state and single-insurer figures, listed in the tables below. They describe one state or one plan and should be cited that way, not as a national rate.

02

How often are claims denied and appealed?

On HealthCare.gov plans, insurers denied 19% of in-network claims in 2024, ranging from 3% to 36% by insurer, and fewer than 1% of denials were appealed. Industry surveys add context but not rates: they are self-reported, not behavioral-health specific, and labelled here as vendor or association figures.

Claim denials and appeals: general (not behavioral-health specific) figures
MeasureValueSource and dateType and caveat
In-network claims denied, HealthCare.gov insurers, 202419% of about 451 million claims; insurer range 3% to 36%KFF, Mar. 24, 2026Independent analysis of CMS public-use data
Denials appealed, 2024Fewer than 1%KFF, Mar. 24, 2026Same data
Internal appeals upheld by the insurer, 202466%KFF, Mar. 24, 2026KFF reports no overturn rate; do not infer one
Denial reasons, 2024Other 36%; administrative 25%; excluded service 13%; no prior authorization or referral 9%; medical necessity 5%KFF, Mar. 24, 2026Share of reasons; a claim can have more than one
Providers reporting denial rates of 10% or more, 202541% (38% in 2024, 30% in 2022)Experian Health, Sept. 22, 2025Vendor survey of 250 provider leaders
Top root causes named by providers, 2025Missing or inaccurate data 50%; authorizations 35%; registration 32%Experian Health, Sept. 22, 2025Vendor survey
Practice leaders naming denials and appeals their biggest revenue-cycle leak48% of 288 responsesMGMA Stat, Jan. 7, 2026Association online poll, self-selected
Average provider cost to contest a denied claim, 2023$57.23 per claim (up from $43.84 for 2022)Premier, Feb. 24, 2025Industry survey of 280 hospitals
03

How often are prior-authorization requests denied?

In the first public metrics required by CMS, insurers denied 12% of standard prior-authorization requests in Medicare Advantage, 14% in Medicaid managed care and 18% in HealthCare.gov plans for 2025. Of denials that were appealed, 67%, 47% and 43% respectively were overturned. Behavioral-health-specific prior-authorization data come only from audits and single-state filings.

Prior authorization: national metrics and behavioral-health data points
MeasureValueSource and dateType and caveat
Standard requests denied, 2025Medicare Advantage 12%; Medicaid managed care 14%; Marketplace 18%KFF, Aug. 13, 202614 large insurers, enrollment-weighted; all services
Expedited requests denied, 2025Medicare Advantage 10%; Medicaid managed care 12%; Marketplace 16%KFF, Aug. 13, 2026Same data
Appealed denials overturned, 2025Medicare Advantage 67%; Medicaid managed care 47%; Marketplace 43%KFF, Aug. 13, 2026Share of denials appealed is not reported
Behavioral-health requests denied, Philadelphia Medicaid BH plan, 20231,102 of 96,130 (about 1.1%)HHS-OIG, June 2026One Medicaid behavioral-health plan
Pre-service denial rate, mental health and substance use vs medical, one Vermont insurer, 20233.80% vs 5.14%Vermont DFR filing, 2023 dataSingle insurer, insurer-reported
Physicians saying prior-authorization requests are often or always denied32% of 1,000AMA survey, May 13, 2026Association survey, all specialties
Peer-to-peer participants saying the plan's reviewer often or always had appropriate qualifications16%AMA survey, May 13, 2026Association survey
04

How often do appeals of behavioral-health denials succeed?

When they reach an independent reviewer, often. In New York's external appeals from 2019 to 2025, reviewers overturned 61.5% of substance use denials and 60.6% of mental health denials, against 46.7% across all categories. California's independent medical reviews overturned 56.3% of plan decisions in 2025, across all conditions.

Independent review outcomes
MeasureValueSource and dateType and caveat
NY external appeals, May 2019 to Dec. 202551,394 closed cases; 46.7% overturned overallJAMA Intern Med, Apr. 13, 2026Peer-reviewed; figures confirmed via published coverage
NY substance use and mental health appeals overturned61.5% and 60.6%MHANYS reprint of MedPage Today, Apr. 15, 2026Secondary report of the JAMA letter
NY overturn rate trend38% in 2019 to 52.5% in 2025MHANYS reprint of MedPage Today, Apr. 15, 2026Secondary report of the JAMA letter
California IMRs resolved in 202556.3% overturned by the reviewer; 21.6% reversed by the plan; 22.1% upheldDMHC 2025 Annual ReportAll conditions; no behavioral-health split published
Philadelphia Medicaid BH plan grievances on prior-authorization denials, 202313 of 63 overturnedHHS-OIG, June 2026One plan
Claim denial rate, mental health and substance use vs medical, one Vermont insurer, 20232.7% vs 5.6%Vermont DFR filing, 2023 dataSingle insurer; cuts against a simple “BH is denied more” story
05

What have regulators found when they audit behavioral-health denials?

Procedural failures and blind spots. HHS-OIG found that none of 100 sampled prior-authorization denials at Philadelphia's Medicaid behavioral-health plan met all requirements, and GAO found that 8 of 9 Medicare Advantage organizations it reviewed required prior authorization for behavioral health while CMS audits had not targeted it.

On the Pennsylvania counts: 711 denials in nine months of 2024 is 82% more than the 391 in all of 2023. A provider association summary described the change as a 45% increase, which is the same difference divided by the 2024 count. We cite the state's counts directly.

Audit and regulator findings
FindingDetailSource and dateType
Sampled denials meeting all federal and state requirements0 of 100; 58 failed more than one requirementHHS-OIG A-03-24-00204, June 2026Government audit, CY2023
Notices missing the right to free copies of the case file100 of 100HHS-OIG A-03-24-00204, June 2026Government audit
Other notice defects17 sent to incorrect addresses; 14 unclear; 1 untimelyHHS-OIG A-03-24-00204, June 2026Government audit
MA organizations requiring prior authorization for behavioral health8 of 9 reviewed (about 45% of MA enrollees); 6 required it for partial hospitalization, 3 of them with internal criteriaGAO-25-107342, May 29, 2025Government audit
CMS follow-upGAO lists the recommendation as implemented: CMS reviewed two behavioral-health services in 2025 and told auditors in May 2026 to consider behavioral-health denialsGAO-25-107342 statusGovernment
Pennsylvania Medicaid BH plans, non-hospital residential SUD service denials448 in 2022; 391 in 2023; 711 in January to September 2024OMHSAS data, Apr. 24, 2025State counts, not rates
06

What is the status of mental health parity enforcement in 2026?

The Departments are not enforcing the new parts of the 2024 parity rule, have told a federal court they will propose a replacement, and now expect to send the draft for White House review by December 18, 2026. The parity statute, the 2013 rule and the 2021 duty to perform comparative analyses still apply.

  • May 15, 2025: the Departments announced they would not enforce the provisions new in the 2024 final rule while litigation continues, plus 18 months (DOL statement).
  • March 30, 2026: in ERISA Industry Committee v. HHS, the Departments told the court they would not defend the 2024 rule and would issue a new proposed rule by December 31, 2026 (joint status reports).
  • September 8, 2026: EBSA's Field Assistance Bulletin 2026-03 set enforcement priorities: separate treatment limitations, medical-necessity standards and review (prior, concurrent and retrospective), and network adequacy (FAB 2026-03).
  • September 30, 2026: a further status report said the draft proposal would go to the Office of Information and Regulatory Affairs by December 18, 2026, with review of up to 90 days, so publication may slip into 2027 (joint status reports).
07

Which commonly repeated figures should you avoid?

Avoid any national behavioral-health denial rate, an “average denial rate near 12%” that appears in sponsored content without a source, an overturn rate inferred from KFF's upheld share, and the “fewer than 1 in 10,000 request external review” figure unless you attribute it to ProPublica, which did not name its source.

  • “Denial rates averaged near 12% in 2025”: stated in sponsored HFMA content with no cited source.
  • A behavioral-health denial rate of 5 to 20 percent: repeated on vendor sites without a traceable dataset.
  • “34% of Marketplace appeals were overturned”: KFF reports that 66% were upheld; the rest may include pending or withdrawn appeals.
  • “Fewer than 1 in 10,000 eligible people request external review”: reported by ProPublica, Sept. 10, 2025 from a report it did not name.
08

How was this page compiled, and how often is it updated?

Every figure was checked against its source on October 14, 2026. Where a publisher blocked automated access, the same document was read from an archived copy of the identical URL. The page is re-verified quarterly and whenever a cited source publishes new data, under our editorial policy.

Sources are ranked as government, peer-reviewed, independent nonprofit, association or vendor. Vendor and association surveys are kept because readers ask about them, but they are labelled and never presented as rates for behavioral health. ClaimParrot publishes no denial or overturn figures of its own. Corrections and new sources are welcome; the editorial policy explains how to send them.

Citation

How to cite this page

For a single number, cite its primary source and date from the tables above; that is what a reader needs to check it. To cite this page as a compilation:

ClaimParrot editorial team. “Behavioral health denial statistics 2026.” ClaimParrot. Updated October 14, 2026. https://claimparrot.com/research/behavioral-health-denial-statistics-2026

Figures marked as vendor or association surveys are self-reported and not specific to behavioral health. This page is re-checked quarterly; the date in the citation tells readers which version you used.

Where ClaimParrot fits

What a ClaimParrot packet does here

  • Records each case's payer, denial category, level of care, deadline and outcome, so a team can measure its own denial and overturn rates instead of relying on national proxies.
  • Keeps the denial notice and the dates with each case, so internal figures can be traced back to their source the same way the figures on this page are.

Every draft is reviewed and approved by your team. ClaimParrot does not make medical-necessity determinations or give legal advice.

Common questions

Frequently asked questions

What percentage of behavioral health claims are denied?

There is no reliable national figure. The closest neutral data are single-state or single-insurer filings, such as one Vermont insurer that denied 2.7% of mental health and substance use claims in 2023. The national 19% figure from KFF covers all in-network claims on HealthCare.gov plans, not behavioral health.

Are mental health claims denied more often than medical claims?

The public data cannot answer that nationally. The few filings that split the two point in different directions; one Vermont insurer reported lower denial rates for mental health and substance use than for medical care. Parity concerns usually involve how criteria and reviews are applied, which rates alone do not show.

How often do people appeal a denied claim?

Rarely. KFF found fewer than 1% of in-network claim denials on HealthCare.gov plans were appealed in 2024. Insurers' prior-authorization reports do not state how many denials were appealed, only how many appealed denials were overturned.

Where can I find a specific insurer's prior-authorization denial rate?

Medicare Advantage, Medicaid and CHIP managed care plans and HealthCare.gov insurers covered by CMS-0057-F must post prior-authorization metrics on their own websites each year. The figures are plan-wide percentages and do not separate behavioral health.

Can I reuse these numbers?

Yes. Cite the primary source for each figure, as linked in the tables, and the date. If you cite this page as a compilation, use the citation in the box above and note the date we checked.

Sources

Primary sources and references

  1. Claims denials and appeals in ACA Marketplace plans in 2024 (Mar. 24, 2026) · KFF · checked
  2. Prior authorization metrics provide new insights into insurer practices, but gaps remain (Aug. 13, 2026) · KFF · checked
  3. Rahim A, Eom KY, Bruch JD. Overturned health insurance claim denials. JAMA Intern Med. 2026;186(6):779-781 (online Apr. 13, 2026) · JAMA Internal Medicine · checked
  4. Huge rates of insurance denials get overturned by independent review experts in behavioral health care services (Apr. 15, 2026; reprint of MedPage Today) · Mental Health Association in New York State · checked
  5. A-03-24-00204: Community Behavioral Health did not comply with requirements when denying prior authorization requests (June 2026) · HHS Office of Inspector General · checked
  6. GAO-25-107342: Medicare Advantage: CMS oversight of prior authorization criteria should target behavioral health services (May 29, 2025) · U.S. Government Accountability Office · checked
  7. Behavioral Health HealthChoices data: denials, grievances and complaints, January 2022 through September 2024 (MAAC meeting, Apr. 24, 2025) · Pennsylvania DHS Office of Mental Health and Substance Abuse Services (hosted by RCPA) · checked
  8. Act 152 reporting worksheet, Blue Cross and Blue Shield of Vermont, reporting year 2023 · Vermont Department of Financial Regulation · checked
  9. 2025 Annual Report (Independent Medical Review results) · California Department of Managed Health Care · checked
  10. Experian Health's 3rd annual State of Claims survey (Sept. 22, 2025) · Experian Health (vendor survey) · checked
  11. MGMA Stat: detecting and fixing leaks across the revenue cycle (Jan. 7, 2026) · Medical Group Management Association · checked
  12. 2025 AMA prior authorization physician survey (released May 13, 2026) · American Medical Association · checked
  13. Claims adjudication costs providers $25.7 billion (Feb. 24, 2025) · Premier Inc. (industry survey) · checked
  14. Statement regarding enforcement of the final rule on requirements related to MHPAEA (May 15, 2025) · U.S. Departments of Labor, HHS and the Treasury · checked
  15. Joint status reports, ERISA Industry Committee v. HHS, No. 1:25-cv-00136 (D.D.C.), Mar. 30, 2026 and Sept. 30, 2026 · U.S. District Court for D.C. filing (via Georgetown litigation tracker) · checked
  16. Field Assistance Bulletin 2026-03: guiding principles for EBSA's enforcement of MHPAEA's NQTL requirements (Sept. 8, 2026) · U.S. Department of Labor, EBSA · checked
  17. “Just let me die”: after insurance repeatedly denied a couple's claims, one psychiatrist was their last hope (Sept. 10, 2025) · ProPublica · checked
  18. Predict, prevent, perform: the AI evolution of denials management (Apr. 13, 2026; sponsored content) · HFMA (sponsored by Conifer Health Solutions) · checked

General information, not legal or medical advice. Payer rules change; confirm deadlines and requirements in the notice and the plan documents. Read our editorial policy.

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