Med Management · E/M · Interventional
Psychiatry & PMHNP Billing Services
We bill for psychiatry and PMHNP practices, where one visit can carry an E/M level, a psychotherapy add-on and a telehealth modifier that all have to match the note. That’s where general billers slip.
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What’s Included
Exactly What You Get.
- E/M visits paired with psychotherapy add-on codes (99214 + 90833).
- Diagnostic evaluations (90792) and new-patient intakes coded to documentation.
- Medication-management visit levels tied to medical decision-making or time.
- Interventional and procedure billing, including Spravato and TMS.
- Telehealth modifiers and place-of-service applied per payer.
- Separate written scope: prior authorization requests and expiration tracking.
- Denial follow-up bucketed by payer, code, and provider.
- We bill your commercial, Medicare and Medicaid claims.
- Payment posting and accounts-receivable reconciliation.
Ongoing Billing runs from 7% of collections with a $300 monthly minimum for a solo provider down to 4.5% at 26 to 50 providers. The monthly minimum is $300 for a solo practice. Solo therapist or counselor? You can start Ongoing Billing online.
We work the claims, denials, payment posting and A/R for medication management, evaluations, Spravato and TMS inside your EHR, under a scope we agree on in writing before any work starts.
The Complexity
Coding General Billers Get Wrong.
Psychiatry mixes evaluation, therapy, medication and procedure codes in the same practice, often in the same visit, and every one of them has to match the note.
E/M + Psychotherapy Add-Ons
99214 with 90833 has to be leveled on medical decision-making, and the therapy minutes in the note have to support the add-on.
Diagnostic Evaluations
90792 intakes coded to what the documentation supports.
Medication Management
Med-check E/M levels tied to medical decision-making or time.
Interventional & Procedures
Spravato, TMS, and procedure coding with their own payer rules.
Telehealth Billing
Modifiers, place-of-service, and originating-site rules that shift by payer and year.
Medication Prior Authorization
Medication authorizations and expiration dates tracked when they’re in the signed scope.
Revenue Visibility
Know What’s Billed, Collected, And Denied.
Collections lag and A/R drifts when nobody can see it. We show what’s billed, what’s collected and what’s still sitting in the queue, by provider, code and payer, so you make decisions on real numbers.
Ask Practice Concierge
How It Works
Three Steps To Cleaner Claims.
Review
We look at the codes on your recent claims, which denials keep coming back, whether every prescriber is enrolled at each payer, and what’s aging in A/R.
Check Codes Against Payer Rules
Your providers choose the codes. We check each claim against payer rules and flag anything that won’t pass, like an add-on billed without its E/M, before the claim goes out.
Run Clean Claims
Claims go out coded correctly and denials get worked. The numbers come to you monthly.
Connected Services
Billing Rarely Lives Alone.
Who This Is For
Psychiatry And PMHNP Practices.
Psychiatrists
E/M, add-ons, med management, and an in-person plus telehealth mix.
PMHNPs
Supervision billing, telehealth-heavy schedules, and enrollment timelines.
Outpatient Practices
Consistent coding across providers and payer types.
Groups Scaling Up
Psychiatry billing support as you add providers and services.
What It Costs
What Psychiatry Billing Costs
Ongoing Billing for psychiatry and PMHNP practices is priced by practice size, from 7% of collections with a $300 monthly minimum for a solo provider down to 4.5% at 26 to 50 providers. There’s no setup fee.
Medical Billing Priced By The Size Of Your Practice
Ongoing Billing
Claims, denials, payment posting, A/R follow-up, reconciliation and a monthly report.
7% of collections
$300 monthly minimum per provider for a solo practice. For 26 to 50 providers: 4.5% with a $175 monthly minimum per provider. No setup fee.
Start Medical Billing Online- Most questions answered within one business day, and up to two meetings a month if you need them
Rate By Practice Size
| Practice Size | Rate | Minimum Per Provider |
|---|---|---|
| 1 provider | 7% | $300 |
| 2 to 5 providers | 6.5% | $275 |
| 6 to 10 providers | 6% | $250 |
| 11 to 25 providers | 5% | $200 |
| 26 to 50 providers | 4.5% | $175 |
- Practices with more than 50 providers can ask us for a written quote.
- Prices checked October 2026.
Here’s where each piece of the work sits.
| Work | How It’s Priced |
|---|---|
| Claim scrubbing and submission, including E/M and add-on pairs, telehealth modifiers and place of service | Included in Ongoing Billing |
| Rejection and denial follow-up | Included in Ongoing Billing |
| Payment posting and adjustments | Included in Ongoing Billing |
| A/R follow-up and reconciliation | Included in Ongoing Billing |
| Reporting by provider and payer | Included in Ongoing Billing |
| Eligibility and benefits verification | Separate written scope |
| Prior authorization for medications | Separate written scope |
| Credentialing and payer enrollment | Per provider and payer, in the pricing builder |
| Unpaid claims older than 90 days | Billing Cleanup And A/R Recovery, 20% of what we collect on them |
When The Backlog Is Already There
Old unpaid claims are a separate job, priced separately. With Billing Cleanup And A/R Recovery we work your unpaid claims older than 90 days, and you pay 20% of what we collect on them. Nothing is owed on a claim we don’t collect. We work your oldest claims first, so nothing ages past a payer’s timely filing limit while we work the rest.
Every unpaid claim gets a reason and a next step, whether that’s a correction, an appeal or billing the right party, and you see where each one stands. In psychiatry, that backlog usually comes from a few repeat causes, like an add-on code that went out without its E/M, a telehealth modifier the payer doesn’t accept, or a prescriber who was never linked to the group at that payer.
We fix those causes as part of the monthly work, so the backlog doesn’t rebuild. Nobody can promise what a payer will pay.
How The Work Runs
From The Visit Note To A Posted Payment
Here is how we handle billing for a psychiatry practice, inside the EHR you already use, whether that’s Valant, Tebra, AdvancedMD, SimplePractice or TherapyNotes.
- Onboarding. We list every prescriber, whether MD, DO or PMHNP, and confirm each one is enrolled and linked to the practice at every payer in scope before their claims go out. We also get authorized access to the EHR, clearinghouse and payer portals, and agree in writing on what stays with your staff.
- Charge review. An E/M visit with a psychotherapy add-on is checked as a pair. The E/M level has to be supported by the note’s medical decision-making, because time can’t set the E/M level once psychotherapy is added on. The add-on has to match the documented psychotherapy minutes, and it only pays alongside its E/M from the same practitioner, for the same patient, on the same date. Evaluations get the same check: 90792 when the evaluation includes medical services, 90791 when it doesn’t.
- Claim scrubbing and submission. Telehealth claims get the modifier and place of service each payer expects: 95 for audio-video or 93 for audio-only, and POS 02 or 10. Claims go out through your clearinghouse, and rejections are read, corrected and resubmitted instead of sitting.
- Denial follow-up. Denials are grouped by payer, CPT code and prescriber. That way a pattern, like one payer refusing the add-on, shows up as one cause with one fix, instead of a stack of separate claims to rework. When a claim denies, we find the cause before we resubmit or appeal, so the same denial doesn’t keep coming back. Now and then a payer approves your credentialing before its contracting team finishes loading you, and early claims deny because of it. We know this lag well, work it directly with the payer, and get those claims reprocessed together instead of one by one.
- Payment posting and adjustments. Each remittance is posted line by line, so a paid 99214 and an unpaid 90833 on the same claim don’t blur into one partial payment. Adjustments carry the payer’s reason, and nothing gets swept into a blanket write-off. We keep each payer’s fee schedule on file, requesting any we don’t have with your permission, and check your payments against it regularly so underpayments get caught and corrected.
- A/R follow-up and reconciliation. Open claims are worked with status checked in Availity or the payer’s portal. Remittances, posted payments, adjustments and deposits are compared before anyone relies on the totals.
- Reporting. A written report each month shows what was billed, collected and denied, and what’s sitting in A/R, by provider and payer, plus what’s still open, who’s working it and when it’s due.
Coding And Cost
Psychiatry Coding And Cost Questions
How Is Psychotherapy Time Counted When 90833 Is Billed With 99214?
Separately. The 99214 has to be leveled on medical decision-making, because time can’t be used to pick the E/M level when psychotherapy is added on. The add-on is picked by the psychotherapy minutes: 90833 for 16 to 37, 90836 for 38 to 52 and 90838 for 53 or more. It only pays alongside its E/M from the same practitioner on the same date, and the note has to document the psychotherapy distinctly from the E/M. There’s more on time ranges in our psychotherapy code guide.
How Is A Medication Management Visit Leveled?
Established-patient office visits, 99212 to 99215, are leveled by medical decision-making or by the practitioner’s total time on the date of the visit. 99213 and 99214 are the common ones for med checks. We check that the level on the claim matches what the note documents before it goes out, because a level set too low loses money and one set too high won’t hold up in an audit.
Do You Handle Prior Authorization For Psychiatric Medications?
When it’s in the signed scope. Medication prior authorization isn’t part of the Ongoing Billing percentage. Once it’s added, the scope lists the authorization requests we handle and the expiration dates we track. Spravato has its own authorization and REMS steps, and we cover those on our Spravato billing services page.
What Does Psychiatry Billing Cost?
Ongoing Billing runs from 7% of collections with a $300 monthly minimum for a solo provider down to 4.5% at 26 to 50 providers. It covers claim scrubbing and submission, rejection and denial follow-up, payment posting and adjustments, A/R follow-up, reconciliation and reporting. Eligibility checks and prior authorization aren’t included unless a separate written scope adds them. Unpaid claims older than 90 days go to Billing Cleanup And A/R Recovery, at 20% of what we collect.
FAQ
Psychiatry Billing FAQs
Do You Support PMHNP Practices?
Yes. Before a PMHNP’s claims go out, we make sure they’re enrolled and linked to the group at every payer in scope. After that, their claims get the same check as any prescriber’s. The note has to support the E/M level and any add-on, and we work denials back to the cause.
Can You Bill E/M With Psychotherapy Add-Ons?
Yes. We check a pair like 99214 + 90833 as a pair. The E/M level has to match the note’s medical decision-making, and the add-on has to match the documented therapy minutes. If a payer keeps denying the combination, we don’t keep resubmitting the same claim. We find out why and fix the cause.
How Does Telehealth Affect Psychiatry Billing?
Each payer sets its own place-of-service and modifier rules for telehealth, and they change. We keep every payer’s current rule in your billing setup, so an audio-only visit doesn’t go out with the video modifier and a visit the patient took from home doesn’t go out with the wrong place of service.
Do You Coordinate Billing With Credentialing?
Yes. We track each provider’s effective date at every payer, and their claims don’t go out to that payer before it. A claim sent early just comes back denied, and then someone has to work it all over again.
What Counts As Collections?
The payer and patient payments we post for your providers from your start date. Your rate is a percentage of those payments, and the monthly minimum applies per provider. Claims already past 90 days and unpaid are a separate job, Billing Cleanup And A/R Recovery.
How Do I Move My Medical Billing To You?
You sign up online, and the first month’s minimum you pay is credited to your first invoice. You get an email invitation to the Command Suite, where you review and sign your Order Form and agreement, and your onboarding packet follows. You give us user access to your EHR, your clearinghouse and your payer portals. Billing starts once your agreements are signed and onboarding is complete, and your rate applies to the payments we post from your start date. Moving from another company? Read Switching Billing Companies.
How Do I Cancel Ongoing Billing?
Either of us can end the agreement with 30 days’ written notice. You owe the fees earned through the end date, and everything we set up in your accounts stays with your practice.
Practice Systems · Improve The Systems Your Practice Already Uses
Billing Worklists With Clear Next Steps
The team can separate payer responses from correctable practice issues, work the next action, and see aging and repeat causes.
What AdvanceAPractice Changes Or Builds
- Follow a few real claims from eligibility through payment and follow up.
- Configure cause categories, assignments, deadlines, reports, and management checks.
- Document whether the next correction belongs to practice staff, the biller, the system administrator, or the payer.
What Your Team Receives
- Denial and payment resolution tracker
- Cause and next action categories
- Aging and repeat issue report
- Weekly review and escalation instructions
Systems We Configure
- Valant, Tebra/Kareo, Office Ally, AdvancedMD, and other outpatient billing systems
- Availity and insurance portals for claim status, eligibility, authorizations, and payment details
- Office Ally, Change Healthcare/Optum, Waystar, TriZetto, and Claim.MD clearinghouse reports
- Excel, Google Sheets, SharePoint, and the Command Suite for A/R worklists and owner reporting
Systems We Assess For This Work
- The practice’s clearinghouse and insurance portals for the transaction and payer in scope
- Valant, Tebra, or another EHR report for charge, claim, payment, or aging detail
- Electronic claim, eligibility, claim status, and remittance files when the supported workflow requires them
Implementation Methods
- Native reports and work queues
- Clearinghouse exports and electronic remittance files
- A manual reconciliation when there’s no automatic way to do it
Access Needed
We need authorized EHR, clearinghouse, and payer access, representative transactions, the current billing workflow, and an owner who can approve corrections.
See Everything Included
Every Step
- We check every claim before it goes out, then submit it.
- We bill your commercial, Medicare and Medicaid claims, whichever you bill.
- We review coding and modifiers on your claims.
- We correct and resubmit rejections.
- When a claim denies, we find the cause before we resubmit or appeal, so the same denial doesn’t keep coming back.
- Now and then a payer approves your credentialing before its contracting team finishes loading you, and early claims deny because of it. We know this lag well, work it directly with the payer, and get those claims reprocessed together instead of one by one.
- We post every payer and patient payment and adjustment for the providers we cover.
- We reconcile what was paid against what was billed, and we reconcile patient accounts.
- We keep each payer’s fee schedule on file, requesting any we don’t have with your permission, and check your payments against it regularly so underpayments get caught and corrected.
- We follow up on unpaid claims with each payer.
- You get a written report each month.
What You Provide
- Your onboarding packet.
- Access as a user in your EHR with billing turned on, your clearinghouse if you use one, and your payer portals.
Timelines
- Within two business days of confirmed payment, you get an email invitation to the AdvanceAPractice Command Suite, where you review and sign your Order Form and agreement.
- Billing starts once your agreements are signed and onboarding is complete.
- Your rate applies to the payments we post from your start date, which means the payer and patient payments we post for your providers. The first month’s minimum you pay at sign up is credited to your first invoice.
- Your rate is 7% of collections with a $300 monthly minimum per provider for one provider, down to 4.5% with a $175 monthly minimum per provider for 26 to 50 providers. There is no setup fee. Your exact rate is written on your Order Form.
What’s Not Included
- Claims older than 90 days. Billing Cleanup And A/R Recovery works those for 20% of what we collect, and nothing is owed on claims we don’t collect.
- Eligibility and benefits checks and prior authorization, unless a written scope includes them.
- Sending statements to patients. That’s its own order.
- Applied behavior analysis (ABA) agencies.
- Fixing denied Medicare or Medicaid enrollment applications.
- Credentialing, which is its own package.
- An EHR. We work inside the one you already use.
Ongoing Support
- Questions are part of working with us, during setup and for as long as you’re a client. Send them in the Command Suite or by email, and we reply within one business day, usually the same day. If a question turns into new work, like a new build or a change to something we built, we send a written quote before we start.
- Up to two meetings a month if you need them.
- Your Command Suite workspace shows what we’re working on and anything we need from you. It stays fully open during the work, read only for 30 days after, and then it’s $99 a month if you want to keep it.
- If something we delivered doesn’t work the way we said it would, tell us within 30 days of delivery and we fix it at no cost.
- Everything we set up is yours. The accounts, the documents and what we build stay with your practice.
- Either of us can end the agreement with 30 days’ written notice.
Want This By Email?
We’ll send you everything above, with the PDF, so you can read it later or share it with your partner or CPA.
See Medical Billing And A/R Options
Ongoing medical billing is priced by practice size. Billing Cleanup And A/R Recovery is based on what we collect. Compare the work, price, and next step before you choose.