Psychiatry Billing Services Minute By Minute.
Psychiatric billing runs on time, setting and plan type: how long therapy lasted, whether medication management happened too, whether the visit was by video or phone, and which behavioral health plan pays. We bill from your session notes and keep up with the rules as they change.
- Therapy, evaluation and medication management
- Telehealth rules current to October 2026
- Behavioral health carve-outs
No real patient or claim data.
Your PsychiatristRecords session time
The Psychiatric Code Families.
Diagnostic Evaluation
Without medical services 90791; with medical services, such as medication review or physical assessment, 90792.
Psychotherapy Alone
By documented face-to-face time: 90832 90834 90837.
Medication Management Plus Therapy
An E/M visit plus a therapy add-on: 90833 90836 90838. Each part documented on its own.
Interactive Complexity
90785 when communication factors, such as interpreters or caregivers in conflict, complicate the service. Not with crisis codes.
Crisis Psychotherapy
First 30 to 74 minutes 90839, each additional 30 minutes 90840.
Family And Group
Family therapy with or without the patient 90847 90846; group therapy 90853.
Telehealth Rules, As They Stand Now.
Medicare's behavioral health telehealth rules changed again this year. Here is where they stand as of CMS's October 2026 guidance. Commercial plans and state Medicaid programs set their own rules.
Therapy At Home
Medicare patients can receive mental and behavioral health telehealth at home.
In-Person Visit Requirement
The Medicare in-person visit requirement for mental health telehealth takes effect after December 31, 2027. We track it and update our process before it takes effect.
Audio-Only
Audio-only behavioral health visits are permitted, with the place of service and modifiers each payer requires.
Source: CMS telehealth FAQ updated October 2026. We recheck payer telehealth policies as they change.
The Plan On The Card May Not Be The Payer.
Many health plans hand behavioral health benefits to a separate managed behavioral health organization, with its own payer ID, network, authorization rules and claims address. Billing the medical plan by mistake leads to a denial.
- Which organization manages the behavioral health benefit
- That each clinician is credentialed with that organization
- Authorization rules for higher-intensity or extended services
- Session limits and when re-authorization is needed
Medicare now also enrolls marriage and family therapists and mental health counselors, so more of your team may bill Medicare directly.
What A Billable Session Note Shows.
Time
Start and stop times or total therapy time, kept separate from E/M time.
Modality
The type of therapy and the interventions used in the session.
Progress
Response to treatment and movement toward treatment plan goals.
Setting
In person, video or audio-only, and where the patient was located.
Collaborative Care, Billed By The Right Practice.
Collaborative Care Model
Billed by the treating practice, usually primary care, with a psychiatric consultant advising a care manager on a shared caseload. If your psychiatrists consult for primary care, the contract decides how they are paid.
General Behavioral Health Integration
Monthly care management time for behavioral conditions, billed by the treating practice when its requirements are met.
Medical Billing Or Full RCM?
Medical Billing
Your front desk keeps registration, eligibility and authorizations. We bill evaluations, therapy, medication management and telehealth visits from your notes and follow every response. Coding can be added.
About Medical Billing Services →Full RCM
We also verify behavioral health benefits and carve-outs, manage authorizations and code every session, with credentialing included for each clinician and plan.
About Full RCM →Inpatient and partial hospitalization facility billing needs its own scope review.
Questions Psychiatry Practices Ask.
Please do not send patient records or session notes through the website.
How Do You Choose Between 90834 And 90837?
From the documented therapy time: 38 to 52 minutes is 90834, 53 minutes or more is 90837. If time is missing, we ask before billing.
Can You Bill Medication Management And Therapy The Same Day?
Yes, as an E/M visit plus a psychotherapy add-on, when each part is documented separately and therapy time excludes E/M time.
Do You Keep Up With Telehealth Rule Changes?
Yes. We follow CMS guidance, currently its October 2026 FAQ, and each commercial plan's and state Medicaid program's policy.
What If A Patient's Behavioral Health Plan Is Separate?
We identify the organization that manages the benefit and bill it directly, after confirming your clinician is credentialed with it.
Can You Help Credential Our Therapists?
Yes. Credentialing is included with Full RCM and can be ordered separately with Medical Billing.
Talk Through Your Psychiatry Billing.
Tell us your visit types, telehealth mix, clinician types and payer mix, including behavioral health plans. Please do not send patient records or session notes through the website.
- Sessions billed by documented time
- BAA signed before any patient-data access
- Medical Billing or Full RCM