Psychiatric practices sit between two billing worlds. A medication management visit is billed like a medical visit, with an evaluation and management code chosen by medical decision-making or time, while the therapy minutes in the same visit are billed with behavioral health add-on codes, often to a different plan than the one on the patient’s card. Maximum Billing handles billing for psychiatrists, psychiatric nurse practitioners, and group practices that combine prescribers and therapists, in twelve states.
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Who We Work With
- Psychiatrists in solo and group practice, including practices that see patients in person and by telehealth.
- Psychiatric mental health nurse practitioners (PMHNPs) who bill under their own NPI.
- Mixed practices where prescribers and therapists share a schedule, a tax ID, and a claims queue.
- Telepsychiatry practices that see patients across state lines and need licensing, credentialing, and place of service handled correctly for each state.
Why Psychiatric Billing Is Different
Most billing problems in psychiatry come from the fact that one visit is two kinds of service. The prescriber’s evaluation and management work and the psychotherapy time follow different coding rules, and both have to be supported in the same note.
- E/M codes are chosen by medical decision-making or total time. Office visits (99202 to 99205 for new patients, 99212 to 99215 for established patients) are leveled on the complexity of the decisions or the total time on the date of service, and the note has to show which one was used.
- Psychotherapy add-ons need their own time. Codes 90833, 90836, and 90838 are reported only with an E/M code, and the psychotherapy minutes must be documented separately from the time spent on the E/M service.
- Behavioral health is often carved out. Many commercial and Medicaid plans send mental health claims to a separate behavioral health administrator, so the payer that pays the visit is not always the one printed on the card.
- Prescribers and therapists are credentialed differently. A plan can have a psychiatrist in network and a nurse practitioner or therapist in the same group out of network.
The Codes Psychiatric Practices Bill Most
- 90792: psychiatric diagnostic evaluation with medical services, the usual intake code for psychiatrists and PMHNPs. Therapists and psychologists bill 90791 instead.
- 99202 to 99215: office and outpatient E/M visits for medication management.
- 90833, 90836, 90838: psychotherapy add-ons of 16 to 37, 38 to 52, and 53 or more minutes when therapy is provided in the same visit as an E/M service.
- 90785: interactive complexity, an add-on for visits where communication factors complicate the service. It is not reported with crisis psychotherapy or with an E/M visit alone.
- 90839 and 90840: psychotherapy for crisis, for the first 60 minutes and each additional 30 minutes.
- G2211: a Medicare add-on for office and outpatient E/M visits that are part of an ongoing, longitudinal relationship, which describes most medication management patients. Commercial plans vary on whether they recognize it.
Practices that consult for primary care offices should know how the psychiatric collaborative care codes work. Under Medicare, the collaborative care codes (99492 to 99494 and G2214) are billed by the treating primary care practitioner, and the psychiatric consultant is paid through an arrangement with that practice. We help practices set up and bill these arrangements correctly.
For a code-by-code look at behavioral health claims in a single state, see our Florida behavioral health and psychiatric billing page.
Where Psychiatric Claims Get Denied
- An add-on code billed without an E/M code, or with psychotherapy time that is not documented separately.
- An E/M level that the note does not support by decision-making or time.
- Claims sent to the medical plan when the behavioral health benefit is carved out to another administrator.
- A nurse practitioner who is not credentialed with the plan, or is billed under a physician’s NPI without a payer rule that allows it.
- Telehealth claims with the wrong place of service code or modifier for that payer.
- Missing prior authorization for services the plan requires it for.
We work every denial by its reason code, correct and resubmit what can be fixed, appeal what was paid wrong, and track patterns so the same denial stops coming back. Our claims denial management page explains the process.
Billing for Psychiatric Nurse Practitioners
PMHNPs carry a growing share of psychiatric visits. They bill under their own NPI, and payer rules for their reimbursement can differ from the rules for psychiatrists. We credential each nurse practitioner with every plan the practice accepts, confirm how each payer reimburses them, and make sure claims go out under the right rendering provider.
Telepsychiatry
Telehealth claims depend on where the patient is. The clinician must be licensed in the patient’s state, and payers differ on place of service codes (02 or 10) and modifiers (such as 95). We check each payer’s current telehealth policy before claims go out, so a visit that was fine in one state is not denied in another.
Credentialing for Prescribers
A psychiatrist or PMHNP who is not enrolled correctly cannot be paid, no matter how clean the claim is. We handle CAQH profiles, commercial plan applications, Medicare enrollment, and state Medicaid enrollment, and we track revalidation dates so enrollment does not lapse. See our mental health credentialing services, or start with our state guides, such as the Florida Medicaid provider enrollment guide.
What We Handle
- Insurance eligibility and benefits checks, including behavioral health carve-outs and authorization requirements.
- Charge entry and coding review for E/M levels and psychotherapy add-ons.
- Clean claim submission and correction of clearinghouse rejections.
- Payment posting, with underpayments flagged against your fee schedules.
- Denial management and appeals.
- Accounts receivable follow-up on every unpaid claim.
- Patient statements and balance questions.
- Credentialing and payer enrollment for psychiatrists, PMHNPs, and therapists.
We work inside the system you already use, including SimplePractice, Sessions Health, TherapyNotes, and InSync. If your group also has therapists, our therapy billing services cover their side of the schedule.
Psychiatric Billing in Twelve States
We bill for behavioral health and psychiatric practices in Colorado, Connecticut, Florida, Georgia, Illinois, Missouri, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, and Texas. Each state page covers that state’s Medicaid program, managed care plans, and payment rules. For the practice-wide picture, including carve-outs and Medicaid managed care, see our mental and behavioral health billing services.
The Numbers We Watch
As of 2026, our clients’ claims reach a 91% clean claim rate, and their accounts receivable average 34 days. The clean claim rate measures how many claims are accepted the first time they are submitted. Days in A/R measures how long it takes, on average, to collect what a practice has billed.
About Maximum Billing
Maximum Billing, LLC was founded in 2018 by Gina Abrotsky-Salvatore, CPCS, MHT, who brings more than 20 years of experience in insurance billing and revenue cycle management. Our office is in Fort Myers, Florida, and our team of certified billing and coding specialists works remotely. We sign a Business Associate Agreement with every client, and every team member completes HIPAA certification. Our HIPAA compliant billing services page explains how we protect patient information.
Frequently Asked Questions
Can a psychiatrist bill an E/M visit and psychotherapy on the same day?
Yes. The E/M code is billed with a psychotherapy add-on code (90833, 90836, or 90838), as long as the psychotherapy time is documented separately from the E/M service and the note supports both.
Do you bill for psychiatric nurse practitioners?
Yes. We credential PMHNPs with each plan, bill under their own NPI, and confirm how each payer reimburses them.
Can you bill telepsychiatry visits in more than one state?
Yes, in the twelve states we serve, as long as the clinician is licensed and credentialed where the patient is located. We check each payer’s telehealth rules for place of service and modifiers.
Do I have to change my EHR?
No. We work inside the practice management system you already use.
Talk to Us About Your Psychiatric Practice
Tell us about your prescribers, payers, and software, and we will review your aging report and recent denials to show you what is still collectible. Contact us to schedule a consultation, or call 800-820-0364.