Revenue Cycle and Practice Support for Psychiatric Practices
Psychiatric billing sits at the intersection of medical billing and behavioral health billing, and getting it wrong in either direction costs money. The E/M with psychotherapy add-on codes, medication management documentation, 90792 evaluations, and collaborative care billing are high-value, high-complexity services that most billing companies get wrong. CareVixis gets them right.
The Specific Challenges Psychiatric Practices Face
Psychiatry sits at the crossroads of medical and behavioral health billing. Psychiatrists must navigate E/M documentation requirements, psychotherapy add-on code eligibility, medication management complexity, and behavioral health carve-out payer rules, all in the same practice. Most billing companies handle one side or the other. CareVixis handles both.
E/M Codes with Psychotherapy Add-Ons: Commonly Missed Revenue
When a psychiatrist provides an evaluation and management service and also delivers psychotherapy during the same session, both the E/M code and the psychotherapy add-on code can be billed. This is legal, appropriate, and specifically supported by CPT guidelines, but it requires precise documentation of medical decision-making for the E/M component and separate time documentation for the psychotherapy component. Most billing companies that handle general medical billing miss the add-on entirely. Most that handle only therapy billing do not know how to pair it with an E/M. CareVixis identifies and captures this revenue on every qualifying visit.
Medication Management Documentation Requirements
Medication management visits changed significantly with the 2021 E/M guidelines. The old history-and-exam approach was replaced by a medical decision-making or total time methodology. Many psychiatric practices are still using documentation templates built around the old system, which means they are either undercoding (leaving money on the table) or overcoding (creating audit risk). CareVixis works with your documentation practices to ensure medication management visits are billed at the correct level supported by the right documentation elements.
Behavioral Health Carve-Out Complexity for Medical Providers
Psychiatrists are physicians, but their services are often covered under the behavioral health carve-out, not the medical benefit. This creates a unique problem: psychiatric claims may need to be submitted to the MBHO (Optum, Carelon, Magellan, or another carve-out payer) even though the provider is credentialed primarily as a physician. Submitting psychiatric claims to the wrong payer results in automatic denials. CareVixis verifies benefit routing for every patient before any claim is submitted.
Complex Prescribing Documentation and Audit Risk
Psychiatrists who prescribe controlled substances face heightened audit risk from both commercial payers and government programs. Documentation of the medical necessity for controlled substance prescriptions, compliance with state PDMP requirements, and appropriate diagnosis coding to support prescribing decisions are all areas where CareVixis provides guidance and monitoring. Inadequate documentation does not just result in denied claims, it can trigger recoupment audits that look back years.
Psychiatric Billing Done by People Who Know Psychiatry
CareVixis handles the full billing complexity of psychiatric practice, from initial psychiatric evaluations through ongoing medication management, through add-on psychotherapy billing, through collaborative care, and through every denial that needs to be fought and reversed.
Complete Psychiatric Billing Workflow
Every service a psychiatrist provides is billed correctly the first time. CareVixis handles psychiatric evaluations, medication management visits, E/M with add-on psychotherapy, crisis services, and collaborative care, each with the documentation review and payer routing that prevents denials before they happen.
- Psychiatric diagnostic evaluation (90791, 90792)
- Medication management E/M visits (99213-99215)
- Psychotherapy add-on codes (90833, 90836, 90838)
- Individual psychotherapy (90832, 90834, 90837)
- Psychiatric crisis services (90839, 90840)
- Collaborative care management (99492, 99493, 99494)
- Telehealth psychiatric visits with correct modifiers
Denial Management for Psychiatric Claims
Psychiatric claims are denied at higher rates than most other specialty claims because they sit at the intersection of medical and behavioral health billing. CareVixis identifies the root cause of every denial the same day it is received and submits corrected claims or appeals immediately. No psychiatric denial is written off without exhausting every available remedy.
- Same-day denial turnaround
- Add-on code denial appeals with documentation support
- Medical necessity appeal letters for evaluation denials
- Carve-out payer routing corrections
- AR follow-up every 14 days, no exceptions
EHR and E-Prescribing for Psychiatric Practices
CareVixis includes a purpose-built mental health EHR with psychiatric evaluation templates, medication management documentation, and EPCS-certified e-prescribing for controlled substances. The EHR documentation captures the elements needed to support the correct E/M level and the correct add-on psychotherapy code on every qualifying visit. Your documentation drives your billing, and the CareVixis EHR is built to make sure the right elements are always present.
- Psychiatric evaluation and intake documentation templates
- Medication management progress note templates
- EPCS-certified controlled substance e-prescribing
- PDMP integration for state monitoring compliance
- Practice-branded telehealth platform
Psychiatric Practice Credentialing
Psychiatric credentialing requires verification of medical degree, residency completion, board certification, DEA registration, state controlled substance registrations, and any hospital privileges. CareVixis manages the full credentialing process for psychiatrists with all relevant payers, including behavioral health carve-outs that frequently require separate enrollment even for physician providers.
- Full commercial payer enrollment and re-credentialing
- Behavioral health carve-out enrollment (Optum, Carelon, Magellan)
- Medicare and Medicaid enrollment by state
- DEA and state controlled substance registration tracking
- Board certification and license expiration monitoring
- Complimentary credentialing assessment for all partners
Everything a Psychiatric Practice Needs. One Fee.
8% of collected billing covers the complete platform. Every service below is part of the same partnership, no add-ons, no separate invoices, no surprises.
Billing and Revenue Cycle
Complete psychiatric billing including E/M codes, add-on psychotherapy, evaluations, medication management, crisis services, and collaborative care. Denial management, AR follow-up, patient billing, and eligibility verification.
Credentialing Support
Optional full credentialing for psychiatrists including behavioral health carve-outs, DEA/license tracking, and board certification monitoring. Complimentary credentialing assessment for all practice partners.
EHR and E-Prescribing
Psychiatric EHR with evaluation templates, medication management documentation, EPCS-certified e-prescribing, and practice-branded telehealth. Or integrate with your existing EHR at no extra cost.
Patient Communications
Automated appointment and payment reminders, HIPAA-compliant two-way messaging, intake form delivery, and online payment options to reduce no-shows and improve patient collections.
Practice Marketing
Psychiatric practice website, local SEO, patient acquisition campaigns, and online reputation management to grow your patient panel and referral relationships.
Practice Reporting
Dashboards for collections, denial rates, AR aging, and payer performance. Reporting by service type and per-clinician reporting for group psychiatric practices.
Frequently Asked Questions
Specific answers to the billing and practice questions psychiatrists and psychiatric practice owners ask most often.
Yes. This is one of the most commonly underbilled areas in psychiatric practice. When a psychiatrist provides an evaluation and management service and also delivers psychotherapy during the same session, both the E/M code (99213-99215 depending on medical decision-making) and the appropriate psychotherapy add-on code (90833 for 16-37 minutes, 90836 for 38-52 minutes, 90838 for 53 or more minutes) can be billed. CareVixis identifies and bills every qualifying add-on on every qualifying visit. This revenue is routinely missed by billing companies that do not specialize in psychiatric billing.
Medication management visits for established patients are billed under E/M codes 99213 through 99215, with the level selected based on medical decision-making complexity or total time (post-2021 guidelines). Many psychiatric practices are still using documentation approaches built for the old history-and-exam methodology, which leads to undercoding or documentation vulnerabilities. CareVixis applies current E/M guidelines to ensure every medication management visit is billed at the correct level with documentation that supports the code selected.
Yes. Collaborative care billing (99492, 99493, 99494) is an underutilized revenue source for psychiatric practices participating in collaborative care models with primary care. CareVixis handles the full workflow, including tracking the monthly time requirements, verifying that registry-based care management documentation is complete, and billing the correct monthly code based on whether the month includes new patient initiation versus ongoing care management.
Yes. The psychiatric diagnostic evaluation code 90792 (with medical services, used when the provider has prescribing authority) and 90791 (without medical services) are both handled by CareVixis. We understand when each code is appropriate, ensure the documentation supports the code billed, and manage prior authorization for initial evaluations when required by the payer.
Psychiatric credentialing involves standard medical credentialing requirements plus DEA registration, state-controlled substance registrations, and board certification in psychiatry. CareVixis manages the complete credentialing process for psychiatrists with all payers, including behavioral health carve-outs that frequently require separate enrollment even for physician providers. A complimentary credentialing assessment is included for all practice partners.
How CareVixis Supports Psychiatric Practices
Psychiatry bills differently from therapy. E/M level selection, psychotherapy add-on codes and controlled substance workflows all have to hold together.
E/M plus add-on codes
90833, 90836 and 90838 attach to an E/M visit and are frequently missed entirely. Our billing and revenue cycle management bills both halves.
Enrollment and DEA-linked workflows
See credentialing and payer enrollment for panel enrollment and recredentialing.
E-prescribing and documentation
See EHR and practice management for psychiatric evaluation templates and medication management documentation.
Telepsychiatry
See practice-branded telehealth, delivered under your practice's own name and branding.
Let's Talk About Your Psychiatric Practice
Whether you are a solo psychiatrist running a medication management practice, a psychiatrist who also provides psychotherapy, or a multi-provider psychiatric group, CareVixis has the billing expertise to handle your complete revenue cycle. Start with a free, no-obligation practice assessment.
No credit card. No obligation.