Specialty billing · Prescriber-led Psychiatry
One appointment. Two billable services. Bill both.
Get more of every psychiatric encounter paid the first time with psychiatric billing services from 247 Medical Billing Services — full-cycle billing for psychiatrists and PMHNPs across Medicare, Medicaid, and commercial payers. Since 2005 we have paired every practice with a dedicated account manager and a free 360° reporting dashboard, all under HIPAA-compliant, SOC 2 Type II workflows built specifically for prescriber-led care.
Psychiatry is the one specialty where a single appointment is routinely two billable services at once — a medication-management evaluation and a psychotherapy session — sitting on top of procedures like TMS and ECT that answer to their own authorization and coding rules. That structure rewards precise coding and quietly penalizes shortcuts, which is exactly why a general biller struggles with it:
A prescriber often performs a medication-management evaluation and psychotherapy in the same visit, billed as an evaluation-and-management service plus a time-based psychotherapy add-on. The add-on only pays when its time is documented apart from the medical work — miss that, and half the visit vanishes off the remit.
A psychiatric diagnostic evaluation with medical services is a different code from one without, and choosing the wrong one either underpays a physician or PMHNP or draws an outright denial.
Psychotherapy is selected by documented time, and interactive complexity pays as an add-on only when a qualifying factor is present and recorded.
ECT and transcranial magnetic stimulation carry distinct coding and — for TMS — prior-authorization and treatment-resistance documentation that a generalist rarely handles well.
With psychiatrists and PMHNPs frequently working side by side, incident-to and supervision rules determine whether a service is paid in full or trimmed back.
Handling all of that on every single encounter is precisely what professional psychiatric billing services are built to do — and it is the difference between a claim that is paid once and one that bounces twice.
We code each element of a psychiatric encounter to its own rulebook, so nothing is left underbilled and nothing is set up to bounce:
99202–9921590833 · 90836 · 9083890785| Service | What it is | What we manage |
|---|---|---|
| Diagnostic evaluation | Psychiatric diagnostic evaluation with or without medical services (90791 / 90792) | The evaluation code matched to the provider and the medical work performed |
| Medication management | Office/outpatient E/M (99202–99215), leveled by MDM or total time | Honest E/M leveling that the note fully supports |
| Psychotherapy add-on | Psychotherapy performed with an E/M (90833 / 90836 / 90838) | Add-on time documented separately from the medical service |
| Standalone & crisis psychotherapy | Psychotherapy by time (90832 / 90834 / 90837) and crisis (90839 / 90840) | The time-correct code, never downcoded or over-reached |
| Interactive complexity | Add-on 90785 when a qualifying factor is present | Applied only when documented, so it survives review |
| ECT, TMS & collaborative care | ECT (90870), TMS (90867–90869), CoCM (99492–99494) | Correct coding with TMS authorization and treatment-resistance support |
Every claim is scrubbed and filed within 24 hours, and practices typically see:
Revenue that used to sit in a work queue starts landing in your account instead.
Psychiatric practices rarely lose money because clinicians work too little — they lose it because the billing model is unforgiving and a small in-house team cannot keep pace with it.
The split visit alone is a trap: the medication-management E/M gets billed, the psychotherapy add-on gets forgotten or stripped for want of separately documented time, and the encounter is quietly paid at half its value, over and over. Add TMS authorizations that expire, evaluation codes that never match the prescriber, and interactive-complexity add-ons that get reported without a qualifying factor, and the leakage compounds every month a claim goes out untended.
When you outsource psychiatric billing services to 247MBS, that entire failure pattern becomes someone else's full-time job. A certified team that already knows psychotherapy add-on timing, medical-versus-non-medical evaluation coding, and the TMS treatment-resistance rulebook works your claims from charge capture through appeal — while your prescribers stay with patients instead of remits. You trade a fixed payroll cost and its coverage gaps for a specialist psychiatric billing company that is measured on how much of your earned revenue actually arrives.
Everything it takes to move a psychiatric claim from the encounter to paid, run by one certified team under a single revenue cycle:
Psychiatrists and PMHNPs enrolled and re-credentialed so nothing rejects on provider eligibility.
TMS and other procedure authorizations secured with the clinical support each payer demands.
Evaluations, medication-management E/M, psychotherapy add-ons, interactive complexity, ECT, TMS, and collaborative care coded straight from the documentation.
Every rejection resolved at source, including add-on, evaluation, and TMS-authorization denials.
Old psychiatric claims chased across every payer until they clear or close.
Want psychiatric billing and coding services under one roof? That's the model here — certified coders and billers on the same team, working from the same record, rather than tossing your claims between vendors.
Revenue review
A certified psychiatric specialist reviews your uncounted psychotherapy add-ons, downcoded evaluations, and aged A/R — and puts a dollar figure on them.
A psychiatric billing specialist will reach out within one business day.
A psychiatric billing specialist will reach out within one business day.
Bringing us on isn't hiring a general biller who happens to accept psychiatric claims. It's hiring a psychiatric billing services company that already speaks the language of how psychiatry gets paid:
The medication-management E/M and the psychotherapy add-on both billed, with add-on time documented so it holds — no more half-paid encounters written off as normal.
The medical-versus-non-medical diagnostic evaluation matched to your prescriber, so physicians and PMHNPs are paid for the work they actually did.
TMS prior authorization and treatment-resistance documentation handled up front, and ECT coded cleanly the first time.
Incident-to and supervision applied by the book, so services aren't reduced or later recouped.
Outpatient clinics, hospital consults, telepsychiatry, and TMS suites each carry a different coding profile, and all of them run through one revenue cycle.
A named account manager and a live dashboard on every account, with no long-term lock-in holding you there.
A generalist learns psychiatry on your claims. We arrive already fluent in it:
Psychotherapy add-on (90833/90836/90838)
Add-on time not documented separately from the E/M → not separately payable
We document add-on time distinct from the medical work
90792 vs 90791 evaluation
Medical evaluation billed as non-medical (or the reverse) → wrong-code denial or underpayment
We match the evaluation code to the provider and medical work
90837 — 60-minute psychotherapy
Below the time threshold → downcode to 90834 or not medically necessary
Time and medical necessity locked at charge capture
TMS (90867–90869)
No prior authorization or treatment-resistance support → authorization absent
We secure TMS authorization and clinical documentation up front
Interactive complexity (90785)
Reported without a qualifying factor → add-on denial
We append 90785 only when a documented factor supports it
Incident-to attribution
Service billed under the physician without meeting supervision rules → recoupment
We attribute each service to the correct prescriber and rules
Every one of these is preventable before submission rather than argued after the fact. Request a revenue review and we'll show you which are landing on your remits right now.
Medication management and psychotherapy across outpatient and hospital settings.
What decides the moneyBoth halves of the split visit captured
Independent and collaborative practice alike.
What decides the moneyIncident-to and attribution by the book
Serving rural and underserved communities where access depends on virtual care. See telehealth billing for the wider virtual rulebook.
What decides the moneyPlace of service and modality modifiers
The psychiatric side of co-occurring care. See SUD billing for the addiction-treatment side.
What decides the moneyTwo rulebooks kept separate
Age-specific evaluation and medication-management billing.
What decides the moneyEvaluation matched to the population
Changing billers shouldn't stall your cash flow, and with us it doesn't.
We work inside your existing practice-management and EHR system, so nobody has to relearn a platform.
Credentialing and payer-enrollment review runs in parallel while your claims keep going out the door, a named account manager leads the transition from day one, and most psychiatric practices are fully live within a few weeks.
From the start we also review your historical claims for the psychotherapy add-ons, medical evaluations, and TMS courses a previous biller may have under-captured, so recoverable revenue from prior months is worked alongside your new claims rather than written off.
The denial drop and faster A/R appear in the first cycles, not a quarter later.
You get paid for the whole encounter, instead of the half a general biller captures.
We bill the medication-management evaluation and the psychotherapy add-on together, secure TMS authorizations before the service, and match every diagnostic evaluation to the prescriber who performed it — so revenue stops quietly falling off your remits. Since 2005 our certified team has run psychiatric medical billing as a med-management-first discipline, and the numbers show it: a first-pass clean-claim rate near 99%, denials down up to 40%, days in A/R held under 25, and roughly nine in ten worked denials overturned on appeal. The payoff is a psychiatrist or PMHNP paid for the full scope of what was delivered, with a named account manager and a live dashboard on every claim. See what your split visits are actually worth
The right psychiatric billing services provider pays for itself in recovered revenue within the first cycles, and 247MBS is built to be that partner.
What changes hands
Outsource psychiatric billing to 247MBS and the split-visit leakage that quietly drains a med-management practice simply stops — for good, and on someone else's clock.
A certified team owns your full revenue cycle: the medication-management E/M and psychotherapy add-on both captured, evaluations matched to the prescriber, TMS authorizations landed before the service, and every denial worked to root cause and appealed on the payer's timeline. You watch all of it on a live dashboard — every claim, denial, and dollar, with no black box.
What outsourcing psychiatric billing services removes is the fragility of a small in-house team that can't keep pace with the rulebook; what psychiatric billing services outsourcing adds is specialist coverage measured on how much of your earned revenue actually arrives, so your prescribers stay with patients instead of remits. See what we would recover for you or call +1 888-502-0537.
NO BOXEvery claim, denial and dollar on a live dashboardNO GAPSpecialist coverage instead of a fragile small teamMEASUREDOn how much of your earned revenue actually arrivesWhether you're a solo psychiatrist, a PMHNP practice, or a multi-site psychiatric group, our psychiatric billing services capture every part of every encounter. Outsource psychiatric billing services to a team that treats the split visit, the evaluation codes, and TMS authorization as routine — and put the revenue you're leaving on the table back where it belongs.
Prefer email? [email protected]