Psychiatry & PMHNP billing
Psychiatry billing services for psychiatrists and PMHNPs
We handle billing for psychiatrists and psychiatric nurse practitioners, from medication-management visits with psychotherapy add-ons to telehealth claims across state lines. Claims go out within 24 hours and every denial is worked within 5 business days.
- E/M + psychotherapy add-on coding (99214 + 90833)
- Telehealth billing in every state you are licensed
- 5 commercial payers credentialed free with billing
Why psychiatry billing is different
Prescriber billing has more ways to go wrong
A psychiatric visit is often two services on one claim, billed by a provider who may be licensed in several states. Small errors turn into denials fast.
E/M plus psychotherapy
When a prescriber provides psychotherapy during a medication visit, the E/M code (such as 99214) is billed with a time-based add-on (90833, 90836 or 90838). Time has to be documented separately from the E/M work, or payers deny or down-code the add-on.
Evaluations
90792 (psychiatric diagnostic evaluation with medical services) is used by prescribers; 90791 is the evaluation without medical services. Payers limit how often each can be billed.
Telehealth rules by payer
Place of service 02 or 10, modifier 95 or none: the right combination depends on the payer and the patient’s location. We keep a payer-by-payer rule set so claims go out right the first time.
Multi-state licensing
Telehealth practices often see patients in many states. Each state and payer needs its own enrollment, and claims only pay when the rendering provider is in-network where the patient is.
Prior authorizations
Some medications, higher levels of care and certain payers need authorization before the visit. We check benefits and authorizations up front so claims don’t come back.
NP billing rules
PMHNPs bill under their own NPI, and many payers reimburse nurse practitioners at a different rate than physicians. We make sure the rendering provider, taxonomy and rates match each contract.
What we handle
Everything between the visit and the payment
- Insurance eligibility and benefits checks before visits
- Charge entry and coding review of E/M levels and add-on codes
- Claim submission within 24 hours of receiving charges
- Payment posting and ERA reconciliation
- Denial correction, resubmission and appeals within 5 business days
- A/R follow-up on unpaid and underpaid claims
- Commercial, Medicare and Medicaid credentialing in every state you serve
- CAQH profile setup and re-attestation
- Patient statements and balance tracking
- Monthly reporting on collections, denials and A/R
Case study
A telehealth psychiatry practice in 23 states
A Georgia-based PMHNP practice with up to 5 providers sees patients by telehealth in 23 states. We have handled their billing, credentialing, denials and A/R for 3 years.
- 100+ payer enrollments completed across 23 states
- $6M+ in claims submitted
- 3 years working together
Common codes
Psychiatry codes we bill every day
| Code | What it is | What we watch for |
|---|---|---|
| 90792 | Psychiatric diagnostic evaluation with medical services | Frequency limits per payer; not billed with an E/M on the same day |
| 99213 / 99214 / 99215 | Established-patient E/M (medication management) | Level supported by medical decision making or total time |
| 90833 / 90836 / 90838 | Psychotherapy add-on with E/M (30 / 45 / 60 min) | Psychotherapy time documented separately from the E/M |
| 90791 | Psychiatric diagnostic evaluation without medical services | Used by non-prescribing clinicians; payer limits apply |
Codes and rules change. We check current CPT guidance and each payer’s policy before submission.
Pricing
Clear pricing for psychiatry practices
Billing starts at 2.5% of collections, or a flat monthly fee. Credentialing starts at $80 per payer, and 5 commercial payers are credentialed free when you sign up for billing.
Common questions
Can a PMHNP bill 99214 and 90833 on the same visit?
Yes, when the visit includes both medication management and psychotherapy, and the psychotherapy time is documented separately from the E/M service. The add-on code depends on psychotherapy time: 90833 for about 30 minutes, 90836 for about 45 and 90838 for about 60.
Do you bill telehealth for patients in other states?
Yes. Our longest-running client sees patients by telehealth in 23 states. We make sure each provider is licensed and enrolled with the patient’s payer in the patient’s state, and we apply each payer’s place-of-service and modifier rules.
How do you get paid?
Billing starts at 2.5% of collections. We also offer flat monthly fees and dedicated billers who work only for your practice.
Can you credential our PMHNPs before we start billing?
Yes. Credentialing starts at $80 per payer, and we credential 5 commercial payers free when you sign up for billing. Government payers such as Medicare and Medicaid are priced separately.
Which EHRs do you work in?
SimplePractice, TherapyNotes, Tebra (Kareo), AdvancedMD, Valant, Osmind, athenahealth, DrChrono and others. We work inside the system you already use.
How fast do you reply?
A real person replies to calls and emails within 1 hour during business hours, Monday to Friday, 9am to 6pm Eastern.
Guides from our team
Learn more before you decide
How to Bill 99214 With 90833: E/M Plus Psychotherapy for Psychiatry and PMHNP Visits
When a prescriber can bill an E/M code with a psychotherapy add-on (90833, 90836, 90838), how to pick each code, what to document, and why these claims get denied.
Read the guide →Spravato (Esketamine) Billing: Codes, REMS, Prior Authorization and Buy-and-Bill
How psychiatry practices bill Spravato: REMS certification, prior authorization, buy-and-bill vs specialty pharmacy, Medicare G2082/G2083 and denials.
Read the guide →TMS Billing: CPT Codes 90867, 90868 and 90869, Prior Authorization and Coverage Criteria
How to bill transcranial magnetic stimulation: the three TMS CPT codes, typical payer coverage criteria, prior authorization, session tracking and common denials.
Read the guide →Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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