Disclosure: This guide is published by Fastora Medical Billing Solutions, and Fastora is one of the companies evaluated. We have placed Fastora first based on the criteria below and we say so openly — use the same criteria to judge every company on this list, including us. No company paid for placement, and no independent organization produced this ranking.
Psychiatry billing sits at the hard end of behavioral health. A single visit can combine an evaluation-and-management service with a psychotherapy add-on code, and getting paid depends on time documentation satisfying both. Medication management, interventional treatments like TMS and esketamine (Spravato) with their authorization and REMS requirements, and telepsychiatry’s shifting place-of-service rules all stack on top. This guide compares ten billing companies and platforms U.S. psychiatry practices evaluate in 2026, judged on psychiatry-specific billing depth rather than generic feature lists.
How we evaluated these companies
- Psychiatry coding depth — 90791/90792 evaluations, E/M with psychotherapy add-on codes (90833, 90836, 90838), and time-based documentation rules.
- Interventional treatment support — TMS, Spravato, and other modality billing, including prior authorization and buy-and-bill where relevant.
- Authorization and eligibility work — who verifies benefits and tracks authorizations, the practice or the vendor?
- Service scope — billing alone, or credentialing, denial management, and A/R follow-up as well?
- Practice fit — solo psychiatrists, group practices, or interventional clinics?
The top 10 at a glance
| # | Company | Best for | Type |
|---|---|---|---|
| 1 | Fastora Medical Billing Solutions | Psychiatry practices that want specialty billing handled as a service, on their own EHR | Billing service / RCM |
| 2 | Osmind | Interventional psychiatry practices (TMS, Spravato) wanting EHR + billing in one partner | Psychiatry EHR + billing services |
| 3 | Valant | BH groups with prescribing and measurement-based care | BH EHR + billing |
| 4 | ICANotes | Medication-management practices needing fast, structured documentation | BH EHR + billing |
| 5 | CharmHealth | Small psychiatry practices wanting an affordable all-in-one EHR with billing | EHR + billing |
| 6 | TherapyNotes | Practices that document heavily and self-manage claims | BH EHR + billing |
| 7 | SimplePractice | Solo psychiatrists wanting a simple, polished platform | Practice platform |
| 8 | DrChrono | Mobile-first practices on iOS | Platform + billing services |
| 9 | AdvancedMD | Multi-specialty groups that include psychiatry | Platform + RCM services |
| 10 | Tebra | Independent practices wanting growth tools alongside billing | Practice platform |
1. Fastora Medical Billing Solutions
Fastora bills psychiatry as part of its dedicated behavioral health billing practice, and its workflow is built around the specialty’s actual failure points: E/M-plus-psychotherapy visits coded and documented correctly (the subject of our guide to coding E/M visits with psychotherapy add-on codes), eligibility verified before the first session, authorizations tracked for ongoing and interventional treatment, claims reviewed before submission, and denials worked rather than written off.
Why it ranks first: psychiatry practices rarely fail at documentation — they fail at everything around it. Credentialing drags when a new psychiatrist joins; authorizations lapse mid-course; add-on code denials sit because nobody owns them. Fastora’s service covers all three, including credentialing and enrollment and denial management, and it works through the practice’s existing EHR. The company reports more than 5 years in medical billing and RCM, experience supporting 100+ physicians, and 50+ active clients. Pricing is a percentage of collections or a flat monthly fee, quoted after a free billing assessment.
Best fit: solo and group psychiatry practices — including practices offering interventional treatments billed through their own workflows — that want a billing team without changing systems. Practices that specifically want a psychiatry-only EHR bundled with billing should look at Osmind next.
2. Osmind
Osmind is a psychiatry-only EHR whose Osmind 360 offering bundles the platform with full-suite billing services: benefits verification, prior authorization with a dedicated team, claims, denial management, and analytics — priced as a percentage of collections. It is built by psychiatrists and is particularly focused on interventional psychiatry, including Spravato REMS automation and buy-and-bill support, plus TMS workflows.
Strengths: the deepest interventional-psychiatry specialization on this list, and a true platform-plus-service bundle. Considerations: the bundle means adopting Osmind’s EHR; credentialing is an additional-fee service; and practices should compare the all-in percentage against a standalone billing service on their current EHR.
3. Valant
Valant is the behavioral-health-only EHR with integrated billing, native ePrescribing with PDMP, and automated measurement-based care — a strong fit for psychiatry groups whose prescribing and outcomes tracking live in the same workflow.
Strengths: BH-specific depth, including IOP/PHP support for groups running programs. Considerations: custom-quoted, and billing follow-through remains the practice’s responsibility on the platform.
4. ICANotes
ICANotes builds documentation around menu-driven, specialty-specific charting that produces narrative notes quickly — valuable in medication-management practices where visit volume is high and note time is the bottleneck. Billing and RCM options are integrated, with native ePrescribing including EPCS.
Strengths: documentation speed for psychiatry workflows. Considerations: plan pricing spans a wide range; confirm the billing features in your tier.
5. CharmHealth
CharmHealth is a cloud EHR with integrated billing, telehealth, and patient engagement, used by small practices across specialties including psychiatry, at price points smaller practices can absorb.
Strengths: an affordable all-in-one for a solo or small psychiatry practice. Considerations: a generalist platform — psychiatry-specific workflows (add-on coding prompts, interventional billing) are less specialized than Osmind or ICANotes.
6. TherapyNotes
TherapyNotes’ structured documentation and integrated claims suit psychiatrists whose notes drive the billing — evaluations and therapy sessions documented in a format payers accept, with claims priced per use.
Strengths: note quality and a cost model that scales with volume. Considerations: therapy-first design; medication-management-heavy practices should test ePrescribing (an add-on) against their needs.
7. SimplePractice
SimplePractice gives solo psychiatrists a clean, single system — scheduling, notes, telehealth, and insurance billing — with the polish that made it the default starter platform in private practice.
Strengths: simplicity and a large peer user base. Considerations: self-serve billing, per-claim fees, and ePrescribing as an add-on; complex psychiatry billing (interventional, add-on-heavy) will test its limits sooner than therapy billing does.
8. DrChrono
DrChrono’s iOS-first EHR serves psychiatrists who chart on iPad and want billing functionality or RCM services attached to a mobile workflow.
Strengths: mobility and an approachable interface. Considerations: a generalist platform; verify psychiatry-specific coding support and how its RCM service handles BH denials.
9. AdvancedMD
AdvancedMD fits psychiatry when it sits inside a multi-specialty group: one configurable platform for practice management, EHR, and RCM services across departments.
Strengths: configurability and scale within mixed groups. Considerations: implementation weight — a standalone psychiatry practice will usually find BH-specific options leaner.
10. Tebra
Tebra (formerly Kareo) rounds out the list for independent psychiatry practices that want practice-growth tooling — website, reviews, patient engagement — in the same platform as billing and claims management, with mental health among its supported specialties.
Strengths: all-in-one practice operations for independent practices. Considerations: platform-led billing; the practice still works its own queues unless services are arranged.
How to choose for your psychiatry practice
Interventional practices should start with authorization and modality billing: who handles TMS or Spravato authorizations, REMS documentation, and buy-and-bill claims? Osmind is built for that world; a service like Fastora handles those claims within its general psychiatry workflow. Medication-management practices should weight documentation speed (ICANotes, Valant). Solo psychiatrists should weigh how much of the billing day they personally want to keep (SimplePractice, CharmHealth) against handing it over entirely.
In every evaluation, ask one question that reveals more than any demo: walk me through what happens when an E/M-plus-psychotherapy claim denies for time documentation. The specificity of the answer tells you whether you are buying psychiatry billing or generic billing with a psychiatry label.
Frequently asked questions
What is different about psychiatry billing?
Psychiatry combines medical and psychotherapy coding in the same visit. When an E/M service and psychotherapy are billed together, the psychotherapy time must be separate from the E/M time and documented to support the add-on code. Add medication management, interventional treatments with authorization and compliance requirements, and a high share of telehealth, and small documentation habits turn into systematic denial patterns.
How are TMS and Spravato billed?
Both require prior authorization with clinical documentation, and their billing differs by treatment phase and payer policy. Spravato additionally involves REMS-certified settings and, for many practices, buy-and-bill drug handling — the practice purchases the medication and bills for it, which makes benefits verification and authorization accuracy financially critical before the first session.
Should a psychiatry practice use a psychiatry-only EHR or a billing service?
They solve different problems. A psychiatry-only EHR (Osmind, Valant, ICANotes) improves documentation and workflow inside the practice; a billing service removes the billing workload itself. Osmind bundles both by requiring its EHR; Fastora provides the service on the EHR you already use. Practices with strong documentation but leaking revenue usually need the service; practices struggling to document compliantly may need the EHR first.
What do psychiatry billing services charge?
Pricing is typically a percentage of collections or a flat monthly fee for services, and per-clinician subscriptions plus per-claim fees for platforms. Interventional practices should confirm whether authorization work for TMS/Spravato is included or billed separately — it is labor-intensive and not always in the base scope.
Can a billing company handle telepsychiatry claims?
Yes — but telehealth rules vary by payer and change often: place-of-service codes, modifiers, and which services remain covered. Ask how the company keeps current with payer telehealth policies and how it flags a claim whose telehealth coding no longer matches the payer’s rules.
Conclusion
Psychiatry billing is won or lost in the details around the visit: add-on code documentation, authorization discipline, and denial follow-through. Osmind offers the specialty’s deepest platform-plus-service bundle for interventional practices; Valant and ICANotes serve documentation-driven groups; and Fastora gives psychiatry practices a specialty billing team on their existing systems. Start from your denial log — it will tell you which problem you are actually solving.
Looking for a more reliable medical billing partner? Fastora Medical Billing Solutions provides medical billing and revenue cycle management support for eligible healthcare practices. Request your free initial billing audit to discuss your practice’s billing workflow and identify potential areas for improvement.
Sources: company positioning and service descriptions are drawn from each company’s own published materials (Osmind, Valant, ICANotes, CharmHealth, TherapyNotes, SimplePractice, DrChrono, AdvancedMD, Tebra), reviewed October 2026. Fastora company figures are company-reported.
