David Cohen, CPA, JD

Guides

• Medicare's 2027 Fee Schedule Still Reaches Your Superbills

  The proposed 2027 Medicare physician fee schedule cuts the conversion factor to $32.8409. Why that moves cash-pay patients' superbill reimbursement.

• Tax Deductions for Psychiatrists: What Therapist Lists Miss

  The prescriber deduction list (DEA, licenses, tail, collab fees) plus the 2026 QBI phase-out math that makes generic therapist tax advice wrong at $300K.

• Subpoena for Mental Health Records: A Prescriber Playbook

  What to do in the first 24 hours after a subpoena for mental health records: the carrier call, order vs. subpoena, psychotherapy notes, and a letter.

• Can a Nurse Practitioner Open Their Own Practice?

  Where a PMHNP can open an independent practice, where a collaborating physician is required, and the entity rules that decide whose name is on the clinic.

• The BAA Checklist: Which Vendors Must Sign, Which Won't

  A vendor-by-vendor BAA table for private practice: email, video, fax, AI scribes, payments, and websites, with each vendor's verified signing posture.

• How to Build a Private Practice While You're Still Employed

  The contract clauses to check, the malpractice gap moonlighting opens, clean NPI and EIN setup, and evening schedules that let a side practice grow.

• Can a Cash-Pay Practice See Medicaid Patients?

  Whether Medicaid patients can pay cash for psychiatry: the enrolled vs. non-enrolled rule, state private-pay agreements, and the $42,425 Massachusetts case.

• Leaving Headway or Alma: The Cash-Pay Exit Playbook

  What leaving Headway or Alma actually takes: the credentialing that stays behind, the charts to export first, the patient letter, and a 90-day exit timeline.

• How to Respond to a Bad Google Review Without a HIPAA Fine

  What the $30,000 Manasa Health Center settlement means for review replies, three HIPAA-safe templates, and how to ask patients for reviews legally.

• A Good Faith Estimate Template for Cash-Pay Psychiatry

  Every patient in a cash-pay psychiatry practice is owed a Good Faith Estimate. The deadlines, required elements, and a template covering a year of care.

• 1099 vs. W-2: What a 60/40 Split Really Pays a Prescriber

  The take-home math on 1099 vs. W-2 at prescriber incomes: self-employment tax, the benefits you must replace, and worked 60/40 splits for MDs and PMHNPs.

• What PMHNPs Actually Make in Cash-Pay Private Practice

  What a cash-pay PMHNP practice grosses and nets at clinician-reported fees: three worked scenarios, overhead, collab fees, and the W-2 median to beat.

• Telehealth Across State Lines: When Your Patient Moves

  The patient-location rule for telehealth across state lines: what to do when a patient moves, travels, or leaves for college, and which states offer shortcuts.

• What Address to Use for Your DEA Registration and Practice

  Which address satisfies DEA registration, your NPI, and your superbills: home address, a UPS Store box, coworking, or a virtual office, scored plainly.

• Can You Charge for Calls, Emails, and Paperwork?

  Seven real questions on billing refill calls, prior auths, and paperwork in a cash-pay psychiatry practice, with the observed rates and scripts that hold up.

• A Credit Card on File Policy That Actually Collects

  A step-by-step card-on-file policy for private practice: when to charge, the script for a declined card, and the paperwork that wins a dispute.

• How Much Savings Do You Need Before Going Private Practice?

  How much to save before quitting for private practice: the delta method, break-even patient counts, and which bridge income options actually help.

• A No-Show Fee Policy Template for Private Practice

  A copyable no-show and late-cancellation policy for cash-pay practices: the business-hours notice window, the card-on-file charge, and when to waive the fee.

• CPT Code 98000: What the 98000-98016 Telehealth Codes Cover

  What CPT codes 98000-98016 cover, why Medicare still won't pay for most of them as of July 2026, and the safer default for a cash-pay telehealth superbill.

• How Much Do Private Practice Psychiatrists Actually Make?

  Three real cash-pay psychiatry P&Ls, from a $180K first year to a $26K-a-month burnout point, plus normal overhead ranges and the arithmetic behind each number.

• Collaborating Physician Cost: What PMHNPs Actually Pay

  Real monthly rates from broker platforms and direct-hire postings, what a collaboration agreement must cover, and what psychiatrists earn supervising NPs.

• Do You Need to Opt Out of Medicare to Go Cash-Pay?

  Whether you must formally opt out of Medicare to charge cash: the affidavit and private contract steps, the W-2 job trap, and a decision table by situation.

• How to Hire a HIPAA-Compliant Virtual Assistant

  A step-by-step guide to hiring a HIPAA-compliant virtual assistant: what to automate first, what to delegate, and how to set up an offshore hire safely.

• 99214 CPT Code: What It Covers and When It Applies

  What CPT 99214 requires, the moderate-MDM and 30-39 minute thresholds that qualify a psychiatric follow-up, and how the 90833 add-on pairs with it correctly.

• Malpractice Tail Coverage: What It Costs Psychiatrists

  What malpractice tail coverage costs, real quoted psychiatrist and PMHNP premiums, occurrence vs. claims-made, and the NSO, Berxi, and MedPli options compared.

• Thrizer vs. Reimbursify: Which Fits Your Practice?

  Verified July 2026 pricing for Thrizer and Reimbursify, what clinicians report breaking, and a framework for when to offer one, both, or neither.

• Which CPT Codes Go on a Cash-Pay Psychiatry Superbill?

  The CPT codes for a cash-pay psychiatry superbill: 90792 vs 99205 for intakes, E/M plus psychotherapy add-ons for follow-ups, and what reimburses patients best.

• How Superbills Work: Out-of-Network Reimbursement Explained

  What a superbill must include, how patients file out-of-network claims, what insurers actually pay back, and the failure modes that stop reimbursement.

• IMLC States and Multi-State Licensing for Telepsychiatry

  Which states are in the IMLC as of 2026, what the compact really costs, and how telepsychiatrists decide which state licenses are worth holding.

• Headway vs Alma vs Grow Therapy: Which Should You Join?

  Clinician-reported rates by CPT code, real referral volume, and exit mechanics for Headway, Alma, and Grow Therapy, from prescribers who used all three.

• What Aetna's Alma Rate Cut Means for Psychiatrists

  Aetna withdrew its Alma rate consolidations on July 9 after clinician pushback, but rates still fall on August 15. What the reversal saved psychiatrists, in dollars.

• How Doctors Accidentally Leak Patient Data to Life Insurers

  Life and disability insurers buy prescription histories, lab results, and clinical records through six channels. Here is the map, and how a cash-pay practice closes the leaks.

• NPI Type 1 vs Type 2: Which One Do You Need?

  Type 1 is you, Type 2 is your business. You only need a Type 2 if your individual NPI is credentialed with insurance, and each NPI goes on different paperwork.

• How to Transition Your Practice From Insurance to Cash Pay

  The step-by-step transition off insurance: the NPI move that clears you to bill cash, the notice letter that keeps half your panel, and the order to drop payers.

• Should Your Psychiatry Practice Take Insurance or Cash-Pay?

  Whether to take insurance or go cash-pay in private practice, decided with arithmetic: what each pays, how fast each fills a panel, and the admin tax insurance hides.

• Do You Need a PLLC to Start a Private Practice?

  No, and a PLLC won't shield you from malpractice either. When incorporating actually saves money, which entity your state requires, and what filing really costs.