Get paid for the full visit, not just the prescription. A psychiatry billing company that captures every E/M level, psychotherapy add-on, Spravato session, and TMS course you deliver.
Nevada Medical Billing provides psychiatry medical billing services for psychiatrists, psychiatric nurse practitioners, and telepsychiatry groups across Nevada. We code medication management visits with the right E/M level and psychotherapy add-on, bill diagnostic evaluations, crisis care, Spravato, and TMS, and manage the authorizations and denials that slow psychiatric claims down. We bill Medicare, Medicare Advantage, Nevada Medicaid and all five of its managed care plans, behavioral health carve-outs, and commercial payers.
Share a few details and a psychiatry billing specialist will review your E/M levels, add-on capture, and denials with you.
Psychiatry revenue rarely disappears in one big denial. It leaks a few dollars at a time, on visits that were billed but billed short.
When a prescriber provides psychotherapy during a medication management visit, the visit can support two codes: an E/M and a psychotherapy add-on. If the therapy time isn't documented separately, or the biller doesn't know to look for it, the practice is paid for half the work.
Psychiatric patients often carry multiple chronic conditions and prescription drug management, which supports moderate medical decision making. Practices that default to 99213 for every follow-up leave money on almost every visit.
Many health plans route behavioral health benefits to a separate behavioral health company. A psychiatry claim sent to the medical plan instead of the carve-out vendor comes back rejected, often weeks later.
Spravato and TMS require prior authorization with documented failed medication trials and treatment history. A missing trial or expired approval turns an expensive course of treatment into an unpaid one.
Place of service, telehealth modifiers, and audio-only rules vary by payer. One wrong combination can deny an entire month of virtual follow-ups.
Psychiatric nurse practitioners bill independently. Nevada grants APRNs full practice authority, so PMHNPs can be credentialed and bill under their own NPI. Nevada Medicaid enrolls physicians as Provider Type 20 and APRNs as Provider Type 24.
Nevada Medicaid managed care is statewide. Since January 2026, managed care covers every county. Psychiatry practices may bill Anthem, CareSource, Health Plan of Nevada, Molina, and SilverSummit, each with its own behavioral health authorization rules.
Medicare is processed by Noridian. Nevada's Medicare Part B claims go to Noridian Healthcare Solutions (Jurisdiction E), and Medicare Advantage plans add their own authorization requirements.
Demand outpaces supply. Behavioral health has the most severe workforce shortage of any specialty area in Nevada, according to the Nevada Health Authority's 2026 workforce assessment. Full schedules leave little staff time for denials and follow-up.
Our psychiatry billing services cover the full revenue cycle, handled by a team that bills behavioral health every day. Choose complete revenue cycle management or the services your practice needs most.
We confirm coverage, identify carve-out vendors, check copays, deductibles, and visit limits, and flag prior authorization requirements before the first appointment. Eligibility Verification
Certified coders review each note to select the E/M level by medical decision making, capture psychotherapy add-ons by documented minutes, and apply the right modifier and place of service. Medical Coding
We build authorization packets with diagnosis history, failed medication trials, and rating scale results, then track approved sessions and renewal dates. Prior Authorization · MAT billing for buprenorphine prescribers
Claims are scrubbed for add-on pairing, NCCI edits, telehealth rules, and payer-specific edits, then submitted within 48 hours of the visit.
We post ERAs daily and compare each payment to your contracted rates, so short-paid add-ons and E/M downcodes don't go unnoticed. Payment Posting
We appeal medical necessity, authorization, and bundling denials with documentation, and use mental health parity rules when payers limit psychiatric care more strictly than medical care. Denial Management
We work every open claim by value and timely filing deadline, including the small follow-up balances most billers ignore. AR Follow-Up
We enroll new prescribers with Medicare, Nevada Medicaid, all five MCOs, carve-out vendors, and commercial plans, and keep CAQH and revalidations current. Credentialing
Clear statements, payment plans, and calm, respectful billing calls that protect the treatment relationship. Patient Billing
Monthly reports show revenue by prescriber, payer, and code, plus add-on capture rate, E/M level distribution, denials, and A/R aging. Revenue Cycle Management
E/M level and add-on capture review
Denial and carve-out routing analysis
Credentialing gap check for every prescriber
We respond within 1 business day. No obligation.
The most common psychiatry billing mistake is billing a two-part visit as one. Here's how a medication management visit with psychotherapy should be coded.
Medication visit · psychiatrist or PMHNP
prescribing, symptoms, risk
Claim line 1: 99212–99215
Level from MDM, never therapy time
minutes noted separately
Claim line 2: add-on by minutes
E/M plus psychotherapy add-on · one visit, two claim lines
The E/M level is chosen by medical decision making only: problems addressed, data reviewed, and risk, including prescription drug management. Psychotherapy time is documented separately and can't be counted toward the E/M level. The add-on code is chosen by those psychotherapy minutes.
Not sure your add-ons are being captured? Get a Free Psychiatry Billing Audit and we'll check a sample of your medication visits.
Get a Free Psychiatry Billing Audit →90792 is for evaluations that include medical services, such as medication review and prescribing, and is billed by psychiatrists and PMHNPs. 90791 is the evaluation without medical services. We confirm the right code by provider and documented content, and check each payer's limits on repeat evaluations.
New and established patient visits leveled by medical decision making or total time (when no psychotherapy is billed). We audit your level distribution so complex psychiatric patients aren't routinely billed as 99213.
Billed only with an E/M on the same date, by the same prescriber, based on documented psychotherapy minutes. When the payer requires it, we apply modifier 25 or 59 per that payer's policy.
An add-on for visits where communication is complicated, such as caregivers with conflicting goals, emotions that interfere with care, or a required report of a sentinel event. We apply it only when documentation supports it.
90839 covers the first 30–74 minutes of crisis care and 90840 each added 30 minutes. Time and the crisis nature of the visit must be documented.
For long E/M visits billed by time, we use 99417 for commercial plans and G2212 for Medicare, based on each payer's time thresholds.
General behavioral health integration, the Collaborative Care Model, and interprofessional consults with primary care. We set up the right billing practitioner and monthly time tracking. primary care billing services
When a psychiatrist provides standalone therapy (90832–90837), family therapy, or group therapy, we bill it under the same time rules our therapy clients use. mental health billing services
Interventional psychiatry brings in high-value claims, and high-value denials. We handle the authorizations and code rules that decide whether they're paid.
| Treatment | Codes | What we manage |
|---|---|---|
| Spravato (esketamine) | Medicare: G2082 (up to 56 mg) and G2083 (over 56 mg), which include the 2-hour observation; commercial plans: E/M or observation codes plus J0013 drug billing per payer policy | REMS-certified site, prior authorization with failed antidepressant trials, buy-and-bill vs pharmacy routing, observation time documentation |
| TMS | 90867 (initial treatment with motor threshold mapping), 90868 (each subsequent session), 90869 (re-mapping) | Authorization for the full course, session counts against approved units, rating scale documentation for renewals |
| ECT | 90870, plus anesthesia billed separately by the anesthesia provider | Facility vs professional billing, treatment course authorization |
Spravato coding differs across Medicare and commercial plans; we confirm each payer's current policy before the first treatment. Explore our Spravato billing services for payer-specific codes, drug reconciliation and phase-based authorizations.
We bill virtual medication management and evaluations with the payer's required place of service (02 or 10), telehealth modifier (95 or GT), and audio-only rules (such as modifier 93), and track Medicare's telemental health requirements, including in-person visit rules. Telepsychiatry groups serving patients across Nevada get one set of payer rules applied consistently to every claim.
| Setting | Codes and rules we apply |
|---|---|
| Private office (POS 11) | E/M with add-ons, evaluations, Spravato and TMS |
| Telehealth (POS 02, 10) | Telehealth modifiers, audio-only rules, payer-specific coverage |
| Hospital consults and inpatient rounds (POS 21, 22) | Hospital E/M (99221–99239), psychotherapy add-ons with hospital E/M, split/shared rules |
| Partial hospitalization and IOP programs | Professional billing for the psychiatrist's services, separate from program billing |
| Community mental health and CCBHCs | Nevada Medicaid encounter and fee schedule rules |
| Denial cause | How we resolve it |
|---|---|
| Add-on billed without a separate E/M or with overlapping time | Correct pairing and documentation, then resubmit |
| E/M downcoded by the payer | Appeal with the medical decision making documented in the note |
| Claim sent to medical plan instead of carve-out | Re-route to the behavioral health vendor within timely filing |
| Spravato or TMS authorization missing or expired | Request retro-authorization where allowed; appeal with treatment history |
| Session or visit limit reached | Request additional visits with progress documentation; use parity rules when limits are stricter than medical care |
| Telehealth place of service or modifier error | Correct per payer policy and resubmit |
| Prescriber not credentialed with the plan | Complete enrollment, then rebill eligible dates |
Every month you get a denial report by payer, code, prescriber, and cause, so problems are fixed at the source.
New prescribers can't bill until they're enrolled, and every week of delay is lost revenue. We credential:
Psychiatrists (MD/DO): Medicare through Noridian, Nevada Medicaid as Provider Type 20, the five Medicaid MCOs, and commercial plans
PMHNPs: independent enrollment under their own NPI using Nevada's full practice authority, including Nevada Medicaid Provider Type 24
Behavioral health carve-out networks that commercial plans use for psychiatric benefits
Ongoing upkeep: CAQH attestations, revalidations, DEA and state license expiration tracking, and new-hire onboarding
| Practice type | What we handle for you |
|---|---|
| Solo psychiatrists | Full billing without hiring staff |
| Multi-provider psychiatric groups | Prescriber-level reporting and centralized credentialing |
| PMHNP-owned practices | Independent NP billing and enrollment |
| Telepsychiatry groups | Virtual visit rules applied consistently across payers |
| Child and adolescent psychiatry | Nevada Medicaid and Nevada Check Up billing, family session codes |
| Interventional psychiatry clinics | Spravato, TMS, and ECT authorizations and billing |
| Addiction psychiatry | Coordination with SUD program billing and 42 CFR Part 2 rules |
| Hospital-affiliated psychiatrists | Professional billing for consults and inpatient rounds |
| Payer category | Plans |
|---|---|
| Medicare | Noridian Healthcare Solutions (Jurisdiction E) |
| Medicare Advantage | Health Plan of Nevada/UnitedHealthcare, Humana, Aetna, Anthem, and other MA plans |
| Nevada Medicaid | Fee-for-service and Nevada Check Up |
| Nevada Medicaid managed care | Anthem Blue Cross and Blue Shield, CareSource, Health Plan of Nevada, Molina Healthcare of Nevada, SilverSummit Healthplan |
| Commercial | Anthem BCBS Nevada, UnitedHealthcare/Optum, Aetna, Cigna, Hometown Health, Prominence Health Plan |
| Behavioral health carve-outs | Vendors that administer mental health benefits for commercial and Medicaid plans |
| Military | TRICARE |
We bill in the systems psychiatric practices use, including AdvancedMD, Valant, Tebra/Kareo, DrChrono, athenahealth, eClinicalWorks, SimplePractice, TherapyNotes, and NextGen. No software change needed. EHR Integration · DrChrono · eClinicalWorks
Free psychiatry billing audit: We review 90 days of claims, E/M levels, add-on capture, denials, and A/R.
Secure setup: We sign a BAA and connect to your EHR, clearinghouse, and payer portals.
Credentialing check: We confirm every psychiatrist and PMHNP is active with each payer and carve-out network.
Authorization inventory: We load active Spravato, TMS, and visit authorizations into tracking.
Go-live: Daily coding, scrubbing, and submission begin.
Legacy A/R cleanup: We work old claims in parallel so nothing ages past timely filing.
Monthly review: KPI report and a call with your dedicated account manager.
These are the performance standards we manage your revenue cycle to, based on industry best practices for psychiatry billing.
| KPI | What it measures | Best-practice target |
|---|---|---|
| First-pass clean claim rate | Claims paid without rework | 95% or higher |
| Denial rate | Claims denied on first submission | Under 5% |
| Days in A/R | Average time from visit to payment | Under 35 days |
| Net collection rate | Collectible dollars actually collected | 96% or higher |
| Add-on capture | Eligible medication visits billed with a psychotherapy add-on | Every visit where therapy time is documented |
| Claim submission | Time from visit to claim sent | Within 48 hours |
Medication visits with documented therapy time but no add-on billed
Follow-ups billed as 99213 when the note supports 99214
Claims rejected because they went to the medical plan, not the carve-out
Spravato or TMS sessions delivered past the authorized count
Telehealth claims with the wrong place of service or modifier
New prescribers seeing patients before enrollment was complete
Psychiatry billing services are usually priced as a percentage of monthly collections. Behavioral health billing commonly runs 4–9%, and outpatient psychiatry practices usually fall in the lower half of that range. Practices with heavy Spravato or TMS authorization work, or large old A/R, fall higher. There are no setup fees, the agreement is month-to-month with 30-day notice, and you get a fixed quote after your free audit.
| Factor | In-house biller | Nevada Medical Billing |
|---|---|---|
| Cost | Salary, benefits, software, training | One fee tied to collections |
| Add-on and E/M coding | Learned on the job | Coders who audit psychiatric levels daily |
| Carve-outs and MCOs | Learned one denial at a time | Already mapped for Nevada payers |
| Spravato and TMS authorizations | Falls on clinical staff | Tracked by our authorization team |
| Absences and turnover | Billing stops | Backup team keeps working |
| Reporting | Manual | Prescriber, code, and payer dashboards |
"Our cash flow will drop." We work old A/R in parallel while new claims go out.
"Our Spravato and TMS auths will lapse." Every active authorization is loaded before go-live.
"We'll lose visibility." You see every claim in your own EHR, plus a monthly review call.
"Our patients' privacy is at risk." We sign a BAA and limit access by role.
"We'll be locked in." You won't. The agreement is month-to-month with 30-day notice.
Psychiatry billing follows CPT and ICD-10-CM guidelines, CMS rules, NCCI edits, payer clinical policies, the Spravato REMS program, mental health parity rules, and HIPAA. Our coding checks medical decision making, psychotherapy time, and prescriber credentials on every claim.
Full-visit coding: E/M levels and psychotherapy add-ons captured on every eligible visit.
Interventional expertise: Spravato, TMS, and ECT authorizations and billing handled end to end.
Nevada payer depth: Noridian, all five Medicaid MCOs, carve-out vendors, and local commercial plans.
PMHNP-ready: Independent NP credentialing and billing under Nevada's full practice authority.
Dedicated account manager: One person who knows your prescribers and payers.
No lock-in: Month-to-month agreement with 30-day notice.
Las Vegas: Psychiatric groups, PMHNP practices, telepsychiatry companies, and interventional clinics offering Spravato and TMS. Las Vegas billing
Henderson: Private psychiatry practices with heavy commercial and carve-out volume. Henderson billing
North Las Vegas: Practices serving many Nevada Medicaid MCO and Medicare Advantage patients. North Las Vegas billing
Reno: Psychiatrists and PMHNPs serving Washoe County and telepsychiatry patients across rural northern Nevada. Reno billing
Carson City: Outpatient psychiatry and rural telehealth programs billing CareSource and SilverSummit. Carson City billing
We also support psychiatric practices in Sparks, Summerlin, Elko, Pahrump, and Mesquite, plus telepsychiatry groups licensed in Nevada.
We help Nevada psychiatric practices capture add-ons, level visits correctly, secure Spravato and TMS authorizations, and clear old A/R.
Free 90-day review · No obligation · HIPAA compliant
Behavioral health billing servicesMental health billing servicesABA billing servicesPrimary care billing servicesPsychiatry billing services cover benefits verification, coding, prior authorization, claim submission, payment posting, denial appeals, A/R follow-up, credentialing, and patient billing for psychiatrists and psychiatric nurse practitioners.
Most charge a percentage of monthly collections. Behavioral health billing commonly runs 4–9%, and outpatient psychiatry practices usually fall in the lower half. We give a fixed quote after a free audit.
Yes. When a prescriber provides both, bill the E/M (leveled by medical decision making) plus a psychotherapy add-on: 90833 for 16–37 minutes, 90836 for 38–52, or 90838 for 53 or more. Therapy time can't count toward the E/M level.
90792 is a psychiatric diagnostic evaluation that includes medical services, such as medication review, and is billed by prescribers. 90791 is the evaluation without medical services.
For Medicare, Spravato visits use G2082 (up to 56 mg) or G2083 (over 56 mg), which include the two-hour observation. Commercial plans vary, often using E/M or observation codes plus a drug code. The site must be REMS-certified, and most plans require prior authorization.
TMS uses 90867 for the initial session with motor threshold mapping, 90868 for each later session, and 90869 for re-mapping. Plans usually require prior authorization showing failed medication trials.
Yes. Nevada grants nurse practitioners full practice authority, so PMHNPs can enroll and bill independently with Medicare, Nevada Medicaid, and commercial plans.
We apply each payer's place of service (02 or 10), telehealth modifier (95 or GT), and audio-only rules, and track Medicare's telemental health requirements.
Yes: Anthem, CareSource, Health Plan of Nevada, Molina, and SilverSummit, plus fee-for-service Nevada Medicaid.
Most practices go live in 2–4 weeks. We load active authorizations first and work old A/R in parallel.
Yes. We work in AdvancedMD, Valant, Tebra, DrChrono, athenahealth, eClinicalWorks, SimplePractice, and other systems.