Psychiatry Billing Services by Prospect Healthcare Solutions
Psychiatry billing services cover the coding, claims, denials and payments for psychiatrists and psychiatric practices, including E/M with psychotherapy add-ons, medication management, TMS and Spravato. Prospect Healthcare Solutions handles authorizations and follow-up, so you can focus on patients.
We support psychiatric practices across the United States from our office in North Smithfield, Rhode Island. If add-on denials or TMS authorization delays are slowing your cash flow, start with a free review of your billing.
Prefer to talk? Call +1 (469) 935-4617.
Why Psychiatry Billing Needs Special Expertise
Psychiatrists bill differently from therapists. A visit often combines medical evaluation and management with timed psychotherapy, and each part must be separately supported. Treatments such as TMS and Spravato add strict authorization and documentation rules, and behavioral health carve-outs can change where a claim goes.
Psychiatry Payer Rules We Manage
These are the psychiatry-specific rules our revenue cycle management team checks on every claim. Rules vary by payer and change often, so we confirm each one against current payer policy.
E/M with psychotherapy add-ons
What it means: Codes 90833, 90836 and 90838 are added to an E/M based on therapy time, and that time cannot count toward E/M time.
How we handle it: We confirm separate documentation and time for each part.
Diagnostic evaluations
What it means: 90792 includes medical services, while 90791 does not.
How we handle it: We match the code to the service and provider type.
TMS authorization
What it means: Payers commonly require a documented diagnosis and failed treatment history, and approve a set course.
How we handle it: We submit records and track approved sessions.
Spravato programs
What it means: Treatment involves REMS requirements, observation and drug benefit rules that differ by plan.
How we handle it: We confirm the medical or pharmacy benefit and bill the applicable codes.
Behavioral health carve-outs
What it means: Some plans send mental health claims to a separate administrator.
How we handle it: We verify the right payer before the visit.
Telepsychiatry
What it means: Telehealth coverage, modifiers and place of service vary by payer and date.
How we handle it: We apply current rules and check patient location.
Our Complete Psychiatry Billing Services
We manage the full psychiatry revenue cycle, from registration and benefit checks to final payment.
1. Eligibility and Authorization Verification
Before the visit we verify behavioral health coverage, the right payer, and authorization, so claims are not denied for avoidable reasons. Learn more about insurance eligibility verification.
2. Psychiatry Coding and Documentation Review
Certified coders assign CPT, HCPCS and ICD-10-CM codes from visit notes, with E/M and therapy time reviewed. See our medical coding services.
3. Clean Claim Submission and Follow-Up
Every claim is checked before submission, then tracked with the payer until it is paid, so nothing is forgotten or left unpaid.
4. Denial Management and Appeals
Every denial is worked through root cause analysis, corrected claims and appeals with supporting records. See our denial management solutions.
5. Payment Posting and Patient Billing
We post and reconcile payments, send clear patient statements, and follow up on balances. Read about our accounts receivable services.
Common Psychiatry Denials and How We Fix Them
Example: an add-on denied without its E/M
The denial. Code 90833 is denied with CARC 16 (claim lacks information) because no E/M was correctly reported.
How we fix it: We check the note, report the E/M and add-on together, and resubmit.
Example: TMS denied for missing authorization
The denial. A TMS session is denied with CARC 197 (precertification or authorization absent).
How we fix it: We check the approval and session count, then correct the claim or appeal with records.
Specialized Psychiatry Billing Services
Medication Management
We bill psychiatric E/M visits and therapy add-ons with time checked.
TMS and Spravato
We bill interventional psychiatry, with authorization and session tracking.
Telepsychiatry
We bill virtual visits. See our mental health billing services and telehealth billing services for related care.
Psychiatry CPT Codes, HCPCS Codes and Modifiers
These are common psychiatry codes and modifiers we work with. Examples only: coverage and payment vary by payer, so we confirm each one before billing.
| Description | Billing note | |
|---|---|---|
| 90791 | Psychiatric evaluation without medical services | Diagnostic visit |
| 90792 | Psychiatric evaluation with medical services | Medical provider |
| 99214 | Established patient E/M | Level from documentation |
| 90833 | Psychotherapy add-on, 30 minutes | With E/M |
| 90836 | Psychotherapy add-on, 45 minutes | With E/M |
| 90838 | Psychotherapy add-on, 60 minutes | With E/M |
| 90839 | Crisis psychotherapy, first 60 minutes | Time required |
| 90867 | TMS initial session | Authorization |
| 90868 | TMS subsequent delivery | Track sessions |
| G2082, G2083 | Spravato visit codes | Payer use varies |
Why Outsource Psychiatry Billing?
Psychiatry billing takes specialized knowledge and steady follow-up. Outsourcing to Prospect Healthcare Solutions gives you:
- Lower overhead than a full in-house billing team
- Time and add-on review
- TMS session tracking
- Faster follow-up on unpaid claims
- Clear reporting for your owners and managers
Psychiatry Billing Compliance
We follow HIPAA, CMS and payer rules to reduce your audit risk and build compliance into every step:
- E/M and therapy documented separately
- Time recorded
- Authorizations retained
- Extra care with sensitive records
- Secure handling of patient information
Who We Serve
Our psychiatry billing services support:
- Psychiatrists
- Psychiatric NPs
- Group psychiatric practices
- TMS and Spravato clinics
- Telepsychiatry providers
We work with providers nationwide, with office support in North Smithfield, Rhode Island. Find your area on our locations page.
Technology and Reporting for Psychiatry Billing
We use billing analytics to catch problems early and keep you informed:
- Real-time claim tracking
- Denial patterns by payer and code
- Add-on and authorization reporting
- Aging accounts receivable reports
- Regular performance reviews
Psychiatry Billing FAQs
What are psychiatry billing services?
They cover authorization, coding, claims, denial management, payment posting and patient billing for psychiatric care.
How is psychiatry billing different from therapy billing?
Psychiatrists often bill an E/M with a psychotherapy add-on, while therapists usually bill psychotherapy codes alone.
Can 90833 be billed alone?
No. It is an add-on code reported with an E/M service.
Does TMS need prior authorization?
Usually yes, and payers commonly want documented treatment history.
Do you bill telepsychiatry?
Yes. We apply each payer rule for telehealth modifiers and place of service.
How do I get a quote for psychiatry billing?
Request a free billing quote online or call +1 (469) 935-4617. We review your current billing and send a plan and pricing.
Partner with Experts in Psychiatry Billing Services
Billing should not distract you from your patients. We handle the coding, claims, denials and compliance so your practice gets paid accurately and on time.