Medication Management Billing
Billing for psychiatric providers, from visit codes to paid claims.
Becker Credentialing Services provides medication management billing for psychiatrists, psychiatric nurse practitioners, and the solo and group practices they work in, in any state. Medication management visits are billed with evaluation and management (E/M) codes, often with a psychotherapy add-on, and getting the level and pairing right on every claim is what keeps you paid for the care you provide.
The Medication Management Codes We Bill
Office and outpatient medication management visits use E/M codes, split by whether the patient is new or established. The level is chosen from either the medical decision-making involved or the total time spent on the day of the visit.
| New patient visit | CPT code |
|---|---|
| Straightforward medical decision-making | 99202 |
| Low medical decision-making | 99203 |
| Moderate medical decision-making | 99204 |
| High medical decision-making | 99205 |
| Established patient visit | CPT code |
|---|---|
| Straightforward medical decision-making | 99212 |
| Low medical decision-making | 99213 |
| Moderate medical decision-making | 99214 |
| High medical decision-making | 99215 |
When the provider also gives psychotherapy during the same visit, a psychotherapy add-on code is billed with the E/M code, based on the time spent on therapy:
| Psychotherapy add-on with an E/M visit | CPT code |
|---|---|
| About 30 minutes of psychotherapy | 90833 |
| About 45 minutes of psychotherapy | 90836 |
| About 60 minutes of psychotherapy | 90838 |
Which codes apply depends on the visit, what's documented, the provider's license type, and each insurance company's rules. Also offer TMS? See our TMS billing services.
Why Medication Management Billing Takes Care
Small coding details make a big difference over hundreds of visits.
The right visit level
Each visit's level has to be supported by the documentation, whether it's chosen by medical decision-making or by time. Levels that don't match the note can lead to denials or repayment requests.
Therapy add-ons
Psychotherapy during a medication visit is billed as an add-on, and its time is counted separately from the E/M service. Missed add-ons mean being paid for only part of the visit.
New or established
New and established patients use different codes, and insurers apply their own rules for which one fits. Using the wrong set is a common, avoidable denial.
License type rules
Psychiatrists, psychiatric nurse practitioners, and physician assistants may face different rules from each insurer about which codes they can bill.
What We Handle for Medication Management Practices
- Insurance eligibility and benefits verification
- Claim creation and submission for E/M visits and psychotherapy add-ons
- Follow-up on unpaid and denied claims until they're resolved
- Payment posting and reconciliation
- Patient statements and invoicing (if requested)
- Monthly revenue and performance reporting
We bill commercial insurance, Medicare, and Medicaid claims for psychiatric practices in any state, including telehealth practices.
How It Works
A clear process, and one person who knows your practice.
Free Billing Review
We start with a conversation about your practice, how you're handling billing today, and how we can help.
Setup
We set up access to your practice's billing system, confirm your payers and effective dates, and set a start date.
Claims & Follow-Up
We verify eligibility, submit claims, and follow up on anything unpaid or denied until it's resolved.
Payments & Reporting
We post payments, reconcile them against what you're owed, and send monthly reports.
Free Billing Review for Psychiatric Practices
Wondering whether outside billing help makes sense for your practice? A free billing review is simply a conversation about your practice, how you're handling billing today, and how we can help.
Medication Management Billing Questions
What CPT codes are used for medication management?
Office and outpatient medication management visits are billed with E/M codes: 99202, 99203, 99204, 99205 for new patients and 99212, 99213, 99214, 99215 for established patients. When psychotherapy is also provided in the same visit, an add-on code (90833, 90836, or 90838) is billed with the E/M code.
How is the E/M level chosen?
The level is based on either the medical decision-making involved in the visit or the total time the provider spent on the day of the visit. Either way, the documentation has to support the level billed.
Can medication management and therapy be billed for the same visit?
Yes, when the psychotherapy is separately identifiable and documented. The E/M code covers the medication management, and a psychotherapy add-on code covers the therapy time, which is counted separately.
Do you bill medication management claims to Medicare and Medicaid?
Yes. Our billing services cover commercial insurance, Medicare, and Medicaid claims.
Can you work with the EHR or practice management system we use?
We've worked with a number of different EHR and practice management systems. Reach out to us to see if we can work with yours.
How is medication management billing priced?
Every practice's needs are different, so we price billing based on your practice. Request a free billing review and we'll talk through what makes sense for you.
Let Us Handle Your Medication Management Billing
Spend less time on claims and more time with patients.
Get a Free Billing ReviewPrefer to talk first? Book a free consultation.