Starting a Psychiatry Practice: 9-Step Billing and Credentialing Checklist
Starting a psychiatry practice means setting up billing and credentialing as carefully as your clinical work. Prescribers face extra pieces: DEA registration, e-prescribing, E/M visits and psychotherapy add-on codes. This nine-step checklist covers the billing side.
What is different when starting a psychiatry practice
Psychiatrists and psychiatric nurse practitioners bill evaluation and management (E/M) codes, often with a psychotherapy add-on. Payers also ask about prescribing credentials. Read billing service for a solo psychiatrist and psychiatry billing services for the overview.
The 9 best steps when starting a psychiatry practice
1. Licenses and registrations
Confirm your state license, DEA registration and any state controlled-substance registration your state requires. DEA registration is tied to the state where you prescribe.
2. NPI and taxonomy
Get your NPI and choose the correct taxonomy for your role.
3. Credentialing
Apply to each payer you want to join and keep your DataSpring profile current. See credentialing and the DataSpring profile guide.
4. EHR with e-prescribing
Pick an EHR that supports electronic prescribing, including controlled substances where allowed, and claims.
5. Coding workflow
Set up E/M and add-on workflows so psychotherapy time is recorded separately. Read psychotherapy add-on codes and documentation requirements.
6. Telehealth policies
Check each payer’s telehealth rules before you schedule remote visits. See telehealth billing rules by payer.
7. Eligibility checks
Verify behavioral health benefits and who manages them. See insurance verification and eligibility checks.
8. Claims and remittances
Set up a clearinghouse and electronic remittance, as described in electronic claims and electronic remittance advice.
9. Billing support
Decide who bills and who follows up on denials. See how to outsource therapy billing.
Private payers vs Medicare vs Medicaid
Private payers
Each plan sets its own credentialing, E/M edits and telehealth rules.
Medicare
Medicare enrollment uses PECOS or the CMS-855I, described on the CMS enrollment applications page. Telehealth rules are on the CMS telehealth page.
Medicaid
State rules and managed care plans vary. See state billing guides.
Plan before you open
Starting a psychiatry practice goes more smoothly when credentialing begins early and billing roles are clear. Review how to choose a mental health billing company if you plan to use a service. Business questions on entity, taxes or contracts belong with a CPA or attorney.
A written plan helps when starting a psychiatry practice, especially for solo prescribers who also manage scheduling and refills. Assign each billing task an owner, keep a payer list with contact routes and review denials each month. Many prescribers also keep a one-page note on how to record E/M work and psychotherapy minutes, so every visit is documented the same way.
Key takeaways
When starting a psychiatry practice, confirm your licenses and DEA registration, get your NPI, credential early, choose an EHR with e-prescribing, separate E/M and psychotherapy time, check telehealth rules and decide who bills.
Frequently asked questions
Do I need a DEA registration to start a psychiatry practice?
If you prescribe controlled substances, yes. It is tied to your prescribing state.
Which codes do psychiatrists bill most?
E/M codes, often with a psychotherapy add-on such as 90833, 90836 or 90838.
When should I start credentialing?
As early as you can, since each payer sets its own schedule.
Can a billing service handle a psychiatry practice?
Many do. Ask whether they handle E/M and add-on coding.
Where MCM South Medical Billing Service Works
MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.
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