Psychiatry billing for psychiatrists, psychiatric nurse practitioners and group practices: evaluations, medication management with psychotherapy add-ons, telehealth, long-acting injections and collaborative care, worked inside the software you already use by a US-based team.
Psychiatry billing services turn every evaluation, medication visit and session into a paid claim. Behavioral health benefits are checked before the first visit, each visit is coded to the decision making, time and psychotherapy the note documents, telehealth goes out with the right place of service and modifier, and every payment, denial and patient balance is followed until it is resolved.
13.3%
of Medicare payments to psychiatry were improper in CMS’s 2025 review, about twice the 6.55% rate across Medicare fee-for-service
52.8%
of those psychiatry errors were incorrect coding; most of the rest, 40.6%, were insufficient documentation
Psychiatry sits between medicine and therapy, and its claims show it. A medication visit is an office visit chosen by decision making or time; add psychotherapy and it becomes two codes with two separate time rules; give a long-acting injection and a drug claim joins them. Behavioral health carve-outs and telehealth rules apply on top.
More than half of psychiatry’s Medicare errors are coding errors. That is why we check every visit’s codes against the note before the claim goes out, not after it is denied.
Most psychiatry practices bill medication visits, psychotherapy add-ons and specialty services such as injections and collaborative care in the same week. Each one pays differently and fails in its own way. Here is where each breaks, and what we do about it.
Pays forOffice visits (99212 to 99215) chosen by medical decision making or time, for evaluation and medication management.
Where it breaks
What we do
Pays forAn office visit plus a psychotherapy add-on (90833, 90836 or 90838) when both are delivered and documented separately.
Where it breaks
What we do
Pays forLong-acting injectable drugs, collaborative care with primary care practices, and video or audio-only visits, each with its own codes.
Where it breaks
What we do
When a psychiatrist or psychiatric nurse practitioner manages medication and provides psychotherapy in the same visit, both can be billed: an office visit (99212 to 99215) and a psychotherapy add-on. The office visit level is chosen by medical decision making, or by time that does not include the psychotherapy minutes.
The add-on is chosen by psychotherapy time alone: 90833 for 16 to 37 minutes, 90836 for 38 to 52, and 90838 for 53 or more. The note has to show the two services separately, so a reviewer can see what was medication management and what was therapy.
What we do: before a combined visit goes out, we check the office visit level and the add-on against the note. If the psychotherapy time or the separation between the services is missing, we tell you the same day, rather than send a claim the note will not support.
These are the codes behind most psychiatry claims, and what payers look for on each one. Behavioral health plans and Medicaid add their own rules, and we check each one.
| Code | What it covers | What payers look for |
|---|---|---|
| 90792 | Psychiatric diagnostic evaluation with medical services | The initial evaluation by a psychiatrist or psychiatric nurse practitioner; not billed with an office visit the same day. |
| 90791 | Psychiatric diagnostic evaluation without medical services | Used when no medical services are provided, usually by therapists. See our mental health insurance billing guide. |
| 99202 to 99215 | Office visits for medication management (E/M) | The level matches the decision making, or the time excluding any psychotherapy. |
| 90833 | Psychotherapy add-on, 30 minutes | 16 to 37 minutes of psychotherapy with an office visit. |
| 90836 | Psychotherapy add-on, 45 minutes | 38 to 52 minutes with an office visit. |
| 90838 | Psychotherapy add-on, 60 minutes | 53 minutes or more with an office visit. |
| 90785 | Interactive complexity, add-on | Only with the specific factor documented; not billed with crisis psychotherapy. |
| 99492 to 99494 | Psychiatric collaborative care management | Monthly care manager minutes, a psychiatric consultant and a patient registry; billed by the treating practice. |
| 96372 | Injection of a long-acting medication | Billed with the drug code and units.MedicareJZ or JW on single-dose containers. |
| 90867 to 90869 | Transcranial magnetic stimulation | Prior authorization from most plans; initial treatment with mapping, later treatments and re-mapping coded separately. |
| G2082G2083 | Esketamine nasal spray, observed self-administration | Up to 56 mg or more than 56 mg, with the observation period documented. |
A synchronous audio-video visit, where the payer requires the modifier.
A visit by phone, only where the payer covers audio-only and asks for the modifier.
Place of service 10 when the patient is at home, and 02 when they are somewhere else, as each payer requires.
An office visit that is significant and separate from a procedure the same day, such as an injection given for another reason. Modifier 25 explained
Required by Medicare on single-dose long-acting injectables: JZ when nothing was discarded, JW for the discarded amount.
A second service that is separate from another billed the same day, used only when the note shows it. Our modifier 59 guide
Sources: CPT psychiatry and E/M guidelines; CMS JW and JZ Modifier FAQs; CMS place of service code set. CPT is a registered trademark of the American Medical Association; the descriptions above are summaries. Reviewed October 2026.
It is not for every practice. If your in-house biller keeps coding errors low and receivables current, keep them, and consider a periodic billing audit instead.
We look at your clean-claim rate, your denials by payer and reason, visit levels and psychotherapy add-ons against your notes, injection claims, and your aging receivables, and tell you what we find, whether or not you go further with us.
We get access to your practice management system and clearinghouse, load each plan's behavioral health, telehealth and authorization rules, list open authorizations, and agree how escalations work. Most practices are live within one to two weeks.
Visits are coded and claims submitted within 24 hours. Rejections are corrected the same day, remittances posted as they arrive, add-ons and injections checked line by line, and denials worked to their cause, all inside your system.
A report you can read in ten minutes: what was billed and collected by payer and clinician, what was denied and why, authorizations close to running out, and what is aging.
You do not change systems to work with Summit Billing Solutions. We work in the practice management and EHR systems below, and through the clearinghouse you already use. If your EHR is not shown, ask; the list grows as we onboard practices.
2%
Average claim rejection rate
24 hrs
Claims submitted within
28
Average days in A/R
They handle my billing with accuracy and efficiency, allowing me to spend more time focusing on my clients instead of administrative tasks.
They continue to amaze me with their strong attention to detail. I cannot recommend them enough!
Most billing companies charge a percentage of what they collect; some charge a flat monthly fee or a per-claim rate. For a psychiatry practice, a percentage usually fits best: the company is paid when you are paid, so the incentive sits where it belongs.
Summit Billing Solutions charges between 3% and 9% of monthly collections. What moves the number for a psychiatry practice is visit volume, the share of visits with psychotherapy add-ons and injections, the number of plans and clinicians, and how clean the receivables are when we take them on, which is why we quote your exact rate after the free account review, not before.
3% to 9%
of monthly collections
We bill for more than 40 specialties, for practices in all 50 states, from Salem, New Hampshire. Each one has its own codes, modifiers and payer rules.
A free account review looks at your clean-claim rate, your denials by payer and reason, visit levels and add-ons against your notes, injection claims and your aging receivables, and tells you what we would change. No cost, no obligation, and no pressure to continue. What the review covers, step by step, is on the free account review page.
50A Northwestern Drive, Salem, NH 03079
603-207-3172
(866) 906-3116
info@summitbillingsolutions.com
Mon - Fri @ 9am - 5pm
What used to create stress for our providers has become a non-issue. Their work is dependable, thorough, and always timely, giving us full confidence that everything is managed correctly.