Psychiatry

Psychiatry Billing & RCM Services

Psychiatry billing lives at the intersection of medical E/M coding and behavioral health rules, add-on psychotherapy codes, med management volume, telepsychiatry compliance, and interventional programs like TMS and Spravato. We bill all of it correctly.

E/M + 90833 Add-On Code Mastery

40% Auth Denial Reduction

TMS & Spravato Program Billing

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The Challenge

Why Does Psychiatry Billing Trip Up Generic Billers?

A psychiatrist's schedule mixes 15-minute med checks, 60-minute evaluations, combined E/M-plus-therapy visits, and interventional procedures. Each visit type has its own coding logic, and payers audit the boundaries between them.

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E/M + Psychotherapy Add-On Coding

Combined visits must bill the E/M (99212-99215) with the correct add-on (90833/90836/90838), with E/M and therapy time documented separately. Billing standalone therapy codes alongside an E/M, or picking an unsupported E/M level, is among the most audited errors in behavioral health.

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High-Volume Med Management

A full med-management schedule can mean 20+ encounters a day. At that volume, small per-claim errors, wrong E/M level, missed add-on, eligibility lapses, compound into serious monthly revenue loss. Clean-claim discipline matters more here than almost anywhere.

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Telepsychiatry & Controlled Substances

Telepsychiatry is now core to psychiatric practice, with POS and modifier rules that differ by payer, plus evolving federal rules around prescribing controlled substances via telehealth. Staying compliant requires tracking rules that change year to year.

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Interventional Psychiatry Programs

TMS (90867-90869) and Spravato programs carry demanding prior authorization criteria, documented medication failures, REMS requirements, observation billing, and generate significant revenue only when the authorization and billing chain is airtight.

Our Approach

RCM Built for the Psychiatric Practice

Our psychiatry billing team handles solo psychiatrists, psychiatric groups, and PMHNP-led practices. We understand the clinical rhythm, evaluations, med checks, combined visits, and the coding that maps to each.

Every claim is scrubbed against payer-specific psychiatry rules before submission, and every denial is worked by someone who knows the difference between a 90833 and a 90834.

Add-on code accuracy, E/M level validation plus correct psychotherapy add-on selection on every combined visit
Evaluation code management, 90791/90792 billed within payer frequency limits with documentation to match
Telepsychiatry compliance, payer-specific POS, modifier, and consent rules maintained as they change
Prescriber credentialing, psychiatrists, PMHNPs, and PAs enrolled and maintained across payer panels

Program Billing

Revenue Programs Beyond the Office Visit

Modern psychiatric practices increasingly run service lines that generic billers mishandle: interventional treatments, collaborative care arrangements, and measurement-based care. We bill each with the specific codes and documentation payers require.

TMS programs, 90867-90869 with prior auth packages built around documented medication trial history
Spravato (esketamine), REMS-compliant observation billing, drug reimbursement coordination, and payer authorization management
Collaborative care (CoCM), 99492-99494 monthly billing for psychiatric consultation embedded in primary care
Measurement-based care, 96127 brief assessment billing integrated into visit workflows where payers reimburse it

FAQ

Frequently Asked Questions

Related Services

Behavioral Health RCM Medical Coding Prior Authorization Credentialing Denial Management

When a psychiatrist performs both medication management (E/M) and psychotherapy in one visit, the psychotherapy is billed with an add-on code: 90833 (16-37 minutes), 90836 (38-52 minutes), or 90838 (53+ minutes) alongside the E/M code (99212-99215). The E/M level must be supported by its own documentation, and the psychotherapy time must be documented separately from the E/M work. Billing the standalone psychotherapy codes (90832/90834/90837) with an E/M on the same day is a common error that triggers denials.

Yes. Telepsychiatry billing spans place-of-service codes (POS 10 for patients at home, POS 02 for other telehealth), modifier -95 for video and -93 for audio-only visits, and payer-specific platform and consent requirements. Prescribing controlled substances via telehealth adds another regulatory layer we track continuously as federal flexibilities evolve.

Yes. TMS uses codes 90867-90869 with strict payer prior authorization criteria including documented failed medication trials. Spravato (esketamine) requires REMS-compliant observation billing alongside the drug itself, buy-and-bill or specialty pharmacy coordination, and payer-specific authorization workflows. Both programs are high-revenue but authorization-intensive, exactly where specialized billing pays for itself.

Yes. PMHNPs and PAs are the fastest-growing prescriber group in psychiatry. We manage their credentialing, apply payer-specific rules on independent vs. supervised billing, and handle incident-to arrangements where they are compliant and financially sensible.

Psychiatric diagnostic evaluations (90791 without medical services, 90792 with) carry payer frequency limits, often once per provider per patient per year, plus documentation standards that differ from routine visits. We track frequency by payer, ensure the right code is used based on whether medical services were performed, and prevent the automatic denials that come from re-billing evaluations too soon.

We integrate with psychiatry-focused platforms including Valant, Osmind, Luminello-successor systems, and TherapyNotes, plus general platforms like athenahealth, AdvancedMD, and eClinicalWorks. Our technical team handles all integration setup at no additional cost.