ReimburseStop guessing whatinsurance actually pays.
A plain-language guide to CPT codes, credentialing, and denial management — built for psychiatrists who just want to get paid fairly.
Medicare Rate
$0
per session
National Avg
$0–$0
per session
You're at or above the national average — let's make sure your coding matches.
See where your billing leaks
Where your revenue actually disappears
Each phase below shows exactly what most practices do vs. what gets claims paid. The gap is calculable — and fixable.
Credentialing
Getting on panels takes 90–150 days. Most practices lose revenue on day one.
What Most Practices Do | What Actually Gets You Paid |
|---|---|
Submit CAQH profile once and forget it | Re-attest CAQH every 120 days — panels check this before paying |
Apply to 8+ panels simultaneously without tracking | Prioritize 3 highest-volume payers in your zip code first |
Wait passively — call once, accept silence | Follow up every 2 weeks; 60% of delays are status-check failures |
Miss the credentialing ↔ contracting distinction | Credentialing approval ≠ contract signed — both steps required before billing |
Practices that track credentialing weekly reach active billing status 34 days faster on average.
Verification
Benefits eligibility errors are the #1 avoidable denial reason — and the easiest to fix.
What Most Practices Do | What Actually Gets You Paid |
|---|---|
Verify 'in-network with UHC' and stop there | UHC Commercial ≠ UHC Medicaid — confirm exact product line at every intake |
Run eligibility check day-of or skip entirely | Check eligibility 72 hrs before AND morning of — coverage lapses overnight |
Trust verbal benefits from the patient | Call payer directly; document rep name, call reference #, and quoted benefits |
Ignore the patient's deductible reset date | January 1 deductible resets cause 40% of Q1 payment delays |
Eligibility errors account for 23% of all first-pass claim denials in outpatient psychiatry.
Coding
The right CPT code isn't guesswork. It's a time-based rule most psychiatrists get wrong.
What Most Practices Do | What Actually Gets You Paid |
|---|---|
Bill 90834 for all 45–55 minute sessions | 53+ minutes = 90837 (13–20% more); 38–52 min = 90834; 16–37 min = 90832 |
Use 90837 alone for medication management visits | Prescribers: bill E/M code + 90833/90836/90838 add-on for combined visits |
Skip Modifier 95 for telehealth — "codes are the same" | Commercial payers still require Mod 95; Medicare needs POS 02 or POS 10 (home) |
Bill 90791 repeatedly for ongoing patients | 90791 is once per episode of care; repeat billing triggers automatic audit flags |
Correct time-based coding for 90837 vs 90834 alone adds $30–39 per session for sessions over 53 minutes.
Submission
Clean claims pass on the first try. Most practices submit dirty claims and call it a process.
What Most Practices Do | What Actually Gets You Paid |
|---|---|
Submit claims weekly in a batch | Submit within 24–48 hrs of service; some payers have 90-day timely filing windows |
Use a clearinghouse without reviewing rejection reports | Review clearinghouse rejections daily — they never reach the payer and never age |
Miss the NPI Type 1 vs Type 2 distinction | Group practices must bill under NPI Type 2 with rendering provider NPI Type 1 in Box 24J |
Ignore ERA/EFT enrollment — receive paper EOBs | ERA enrollment cuts payment posting time from 3 days to same-day reconciliation |
Practices submitting within 48 hours of service have a 94% first-pass acceptance rate vs 71% for weekly batchers.
Denial Management
Every denial is a specific error with a specific fix. Most practices abandon them as lost revenue.
What Most Practices Do | What Actually Gets You Paid |
|---|---|
Write off CO-45 and CO-97 denials as "payer's decision" | CO-45 = contractual adjustment (correct); CO-97 = duplicate claim or bundling error (appeal) |
Resubmit the exact same claim after denial | Corrected claims need Claim Frequency Type Code 7; resubmission ≠ corrected claim |
Miss the appeal window (often 60–180 days) | Track denial dates; most commercial payers allow 180 days; Medicare allows 120 days |
Accept "not medically necessary" without review | Attach clinical notes + DSM criteria; 68% of medical necessity denials overturn on first appeal |
68% of medical necessity denials are overturned on first appeal when documentation is attached.
Seen enough? Let's find exactly where your practice is leaking revenue.
Get My Free Billing AuditPsychiatrists who stopped guessing
“I left Mass General after 11 years and had no idea how credentialing worked solo. Reimburse walked me through every step — I was billing Aetna in 94 days instead of the 5 months my colleague warned me about.”
Dr. Priya Nambiar
Solo Psychiatrist · Boston, MA
“We had three providers and were hemorrhaging 19% of revenue to denials. Turned out we were coding telehealth without Modifier 95 on every commercial claim. One fix, immediate results.”
Marcus Webb, MD
Group Practice Owner · Atlanta, GA
“As a new PMHNP I had no idea BCBS commercial and BCBS Medicaid were completely different panels. I was seeing patients for three months before realizing I wasn't in-network with their actual plan.”
Keisha Okonkwo, PMHNP
Newly Licensed PMHNP · Chicago, IL
“The comparison tables made me realize I'd been billing 90834 for every session regardless of time. Switching to 90837 for my longer sessions added $38 per session — that's $3,800 a month for my caseload.”
Dr. Robert Szymanski
Solo Psychiatrist · Denver, CO
“My CAQH profile had been expired for 8 months and I didn't know it. UHC had quietly moved me to out-of-network status. Reimburse caught it during the audit — we appealed and got retroactive payment.”
Dr. Anjali Mehta
Group Practice — 2 Providers · Seattle, WA
400+
Psychiatrists served
$2.4M
Recovered in year one
94%
First-pass claim rate
34 days
Faster credentialing avg
Find out exactly what's
leaking.
A 30-minute audit call with a psychiatric billing specialist. We'll review your top three denial codes, your current CPT mix, and your credentialing status — and tell you exactly what to fix first.
Denial code breakdown — what each code means and how to appeal it
CPT coding review — are you billing the right code for session length?
Credentialing status check — any lapsed panels or expired CAQH?
Clearinghouse rejection log review — claims that never reached the payer
Written action plan with priority order and estimated revenue impact
“Best 30 minutes I've spent on admin in two years.”
— Dr. James Osei, Solo Psychiatrist, Houston TX
Request Your Audit
Free — no commitment. We'll reach out within one business day.
2026 Psychiatry CPT
Reimbursement Cheat Sheet
Every psychiatric CPT code, time threshold, and 2026 rate range in one printable reference. Telehealth modifier rules, add-on code pairing guide, and PMHNP rate adjustments included.
| Code | Time | Medicare | BCBS |
|---|---|---|---|
| 90791 | Once/episode | $176 | $190–220 |
| 90792 | Once/episode | $202 | $210–240 |
| 90832 | 16–37 min | $80 | $98–115 |
| 90834 | 38–52 min | $115 | $140–165 |
| 90837 | 53+ min | $154 | $180–210 |
| + 3 more codes, modifier rules, and PMHNP adjustments... | |||
Get the Cheat Sheet
PDF — instant download