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. 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.
See PricingWhat’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.
- Payment posting and accounts-receivable reconciliation.
Ongoing Billing runs from 7% of collections for a solo provider down to 4.5% for 26 or more providers. The monthly minimum is $300 for a solo practice. Solo therapist or counselor? Use our self-serve path instead.
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 actually 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.
Align Notes And Codes
We check each note against the code on the claim. If the medical decision-making doesn’t support the E/M level, or the therapy minutes don’t support the add-on, we flag it 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 for a solo provider down to 4.5% for 26 or more providers, or by your monthly collections when that rate is lower. Groups of 6 or more can pay $7 per paid visit for their psychiatrists and PMHNPs instead. There’s no setup fee, a newly added prescriber has no minimum for their first 90 days, and the rate drops half a percentage point when we also handle your credentialing.
Billing Priced By The Size Of Your Practice
Your rate drops as you grow: 7% of collections for a solo provider with a $300 monthly minimum, down to 4.5% at 26 to 50 providers. You get whichever rate is lower, by provider count or by monthly collections. There's no setup fee.
Ongoing Billing
Claims, denials, payment posting, A/R follow-up, reconciliation and a monthly report.
7% of collections, 1 provider
$300 monthly minimum. No setup fee.
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- When we handle your credentialing too, the rate is 0.5 point lower.
- We also work unpaid claims older than 90 days for 20% of what we collect on them. Nothing is owed on claims we don't collect.
Rate By Practice Size
A practice with a few busy prescribers often qualifies on collections.
| Practice Size | Rate | Minimum Per Provider |
|---|---|---|
| 1 providerUnder $25,000 a month | 7% | $300 |
| 2 to 5 providers$25,000 to $75,000 | 6.5% | $275 |
| 6 to 10 providers$75,000 to $150,000 | 6% | $250 |
| 11 to 25 providers$150,000 to $300,000 | 5% | $200 |
| 26 to 50 providersOver $300,000 | 4.5% | $175 |
- Each month you get a written report on what was billed, collected and denied, and what we did about it.
- Groups of six or more can bill psychiatrists and PMHNPs at $7 per paid visit instead of the percentage. Therapists stay on the percentage.
- A provider you add later has no minimum for their first 90 days, while they build a caseload.
- Practices with more than 50 providers, or very high claim volume, can ask us for a per-claim price.
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. 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
AdvanceAPractice’s founder, Ryan Berg, has 16+ years in revenue cycle. Here’s the order the work runs in 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.
- 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.
- 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 for a solo provider down to 4.5% for 26 or more providers, and groups of 6 or more can pay $7 per paid visit for psychiatrists and PMHNPs. 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.
Practice Systems · Improve The Systems Your Practice Already Uses
Revenue Cycle Work Queues That Show The Next Action
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
- Trace representative eligibility, claim, remittance, posting, and follow-up records.
- 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
- Controlled reconciliation when no supported automated path exists
Access Needed
We need authorized EHR, clearinghouse, and payer access, representative transactions, the current billing workflow, and an owner who can approve corrections.
What Would Fixing It Cost?
Ongoing Billing, Automation Programs and the Operations Partnership each have a published price and a written scope. Tell us what keeps going wrong, and we’ll point you to the right one.