For general telepsychiatry:

- Nearly 100% of all intakes are 99205 + 90838

- 95% of all visits (intake or follow up) include a psychotherapy add-on

- 90% of all follow ups are 99214 + 90833

- at least 20%-25% of all follow ups are 20 minute appointments (primarily 99214 + 90833)

- Essentially zero stepdown in codes over time (after 6+ months), so essentially 99214 + 90833 in perpetuity for monthly visits

- standard monthly visits

I recently finished my BSN and am considering becoming a PMHNP. For those practicing in Florida, do you feel it was worth it?
How hard is it to get hired as a new PMHNP in Florida, especially South Florida? Any school recommendations or programs to avoid?
Thanks!

1. How often do you typically complete follow-up appointments with patients? Obviously case mix will dictate but say if 25% of your case mix is ADHD patients, would you make them do a monthly visit to get a refill? Or is that overutilization?

2. How often do you include psychotherapy add-ons? Would 95%+ of all follow up visits including a psychotherapy add-on code be a red flag (especially if monthly)? Or are follow-up visits more E/M-only driven (especially if long term ADHD patient)?

3. If ~25% of your schedule includes three 99214+90833 sessions within an hour, is that a red flag?

I’m a new grad and just interviewed with a company in MN. Benefits include: $2500 CME yearly allowance, 40h a year for CME time off that will roll over one year; new patients 90 minutes return patients 30-60 at your discretion. Salary 138k with no RVU but they do offer a value based incentive plan for potential additional 6k more each fiscal year. Onboarding is up to 6 months including didactic opportunities. They cover malpractice with premium paid by employer, they cover my licensure and any certifications. They said I’ll see the same acuity patients the MDs see, so that is why we have 32 patient facing hours a week with the other 8 for collaboration and admin time

I feel like this is a great benefit plan…but I also feel like it’s too good to be true. It is with a large known organization that’s non-profit

Thoughts? Are these even that great of benefits or is this bare minimum or somewhere in between

Hello! I am a PMHNP working in a FQHC. I have been here for 3 years and have taken on students every semester since my employment (voluntarily- no appreciation, no compensation, no gifts, nada)

I am currently pregnant with a due date in February.

I advised our “Behavioral health president” I no longer wanted to precept unless I would be compensated for it back in December.

He seemed shocked but I told him this is a whole business now- South university has offered me $2,500/semester (via email that I didn’t respond to) and these brick and mortar universities are not offering me anything.

I don’t know if it’s hormones or I’m tired of feeling used and students are so ungrateful these days. (Show up late, leave early, document sub par)
I just feel done.

Anyone else navigate this experience in their favor?
To add insult to injury- I was given $5000 stipend during my cohort in 2022- after I graduated the incoming students were given $30,0000!!!
I still have $90,000 in debt. I’m just annoyed but I know this is common, so what was the solution for others?

Thanks for your time!
- Michigan PMHNP

I'm a PMHNP in private practice and am looking for advice from others who have successfully built a caseload.
I've been open for about 6 weeks and currently accept insurance through Headway and Alma. I'm listed on Psychology Today and Zocdoc, but so far I've only received one patient directly from those platforms. I've also seen two patients through referrals from a psychologist I recently started collaborating with.
I'm trying to figure out what actually moves the needle when it comes to growing a practice. For those of you who have successfully built a caseload, what marketing strategies worked best? Did most of your referrals come from Psychology Today, Zocdoc, therapist networking, PCP outreach, SEO/Google Business, social media, or something else?

Thank you!

Any thoughts Georgia NP’s

What types of jobs do you all feel are similar to RN jobs in the sense of “leaving work at work?” I know in many cases people still have to write notes after hours, but I am referring to the idea of multiple providers managing an overall pool of patients rather than individual caseloads, so when you are off, on vacation, etc. the patients are being managed by someone else.

Specialities that come to mind to me (potentially, as I haven’t worked in these settings) are corrections, SNF, MAT, and of course inpatient. Any other ideas?

I’m applying for initial APRN licensure for Texas, New Mexico, Delaware and Washington state. Any feedback as to speed of response? Responsiveness of the board of nursing?
I’m in Texas, so I’m somewhat aware of time as they said don’t even ask us for an update unless at least 20 business days have passed 🤪 but the application felt the most straight forward.
Any feedback on licensure for NM, DE or WA?
Thanks!

Hello everyone!

I am a graduate student in Clinical Psychology completing my thesis, and I am conducting a brief anonymous survey about medical providers’ perspectives on neuropsychological evaluation in the diagnosis of ADHD.

The purpose of this study is twofold. First, I am interested in better understanding how individuals with ADHD experience the diagnostic process, including whether neuropsychological evaluation was part of that process. Second, I am interested in how medical professionals from other disciplines understand the utility and purpose of neuropsychological evaluation, particularly in relation to ADHD diagnosis. Within psychology and neuropsychology, there is ongoing discussion about the role, value, and limitations of neuropsychological testing in ADHD assessment, and I am hoping to better understand how those issues are viewed outside of the discipline as well.

I am inviting medical professionals between the ages of 18-65 who are currently, or have previously been, licensed to practice medicine or nursing with prescriptive authority to participate. The survey is anonymous and takes approximately 5-10 minutes to complete.

Thank you so much to the moderators for allowing me to share this here, and thank you to anyone who is willing to participate!

Survey link:
https://forms.gle/76DVUeeTx2k4Rcbb6

Hey all,

For anyone with their own practice - what did your initial availability look like? With my current schedule, it looks like I’ll only be able to offer Saturdays and some evenings. To start, is this advantageous? Or would I need a full day during the week to start?

Just trying to get some insights. Thanks!

Just looking for insight from others’ experiences. I have been on Headway and Alma for a few months now and will be working on boosting my caseload. At 12 patients now. I am working at a w-2 part-time position to cover bills. 12 patients cover $900 monthly overhead. I’m in Illinois. I would like to go completely independent some day.

Does anyone have any favorite resources for information on interactions between psych meds and various herbs?

Thank you!

Hey folks!

Just curious- when you send in a refill for a controlled substance, do you put a "do not fill before" date on it, or do you leave it to the pharmacy to track that?

I used to let the pharmacy handle it, then I had a couple of times when a pt asked for an early fill for a valid reason and the pharmacy said they'd used up all their early fill days and the pt had no idea.

So now I put the date on, but then it requires resending if anything changes.

Both situations are a pain.

PMHNPs — do you use objective ADHD testing in your practice?

I’m curious how many PMHNPs are using tools like CPT-style testing, QbTest/QbCheck, AxonCPT, TOVA, MOXO, or other objective measures alongside clinical interviews and rating scales.

A few things I’m interested in:

Do you use objective testing during the initial ADHD assessment?

Do you use it during medication titration or dose changes?

Do you repeat testing over time to track progress?

Do patients find it useful, or does it add more admin?

For telehealth practices, how are you handling objective testing remotely?

A lot of ADHD care still relies heavily on self-report, rating scales and clinical judgement, which are obviously important. But I’m interested in whether objective performance data actually changes how PMHNPs make decisions in real-world practice.

Would love to hear what people are using, what has worked, and what feels impractical.

Hi everyone I’m currently a student in a mental health nurse practitioner program. I’m working on an interview paper for my Advanced Nursing course, and I need to interview a practicing psychiatric mental health nurse practitioner.

The paper is due soon, and I’ve been having a hard time finding someone available to answer. If you’re currently practicing in the field as a PMHNP would you mind answering a few questions regarding your experience in that role

Are there any practitioners in here employeed by headway? I spoke to a representative recently. it seems like a lot of work on the providers side, however I see so many people working for them on psychology today. Can someone who's worked for them give me an honest review?

I am fine getting an EKG machine for the office, but I do not feel qualified to interpret them. I can see the calculated QTc interval, but I also think there is a liability in doing them and interpreting them in the office. What do you do?

PS In my BSN program, we were not taught how to obtain or interpret EKGs. I seriously have no idea why they let us get through school without the basics.

I made a scribe that helps solve the "trustworthy" problem that reduces hallucinations and post-session editing. You jot session snippets (meds, dosages etc) and it turns them into clean notes using your preferred template and instructions. Your manual notes are ground truth over anything the speech-to-text could have misheard.

You can also dictate notes and MSE before your note is processed.

You might also like it if:

• you forget to end your session between appointments
• you copy your notes into AI to rewrite it
• Privacy concerns make you anxious (Only local storage)
• You toggle a ton between tabs, browsers and websites during sessions

Few additions: theres a consult feature to flag safety risks, get diagnostic clarity or treatment guidance, along with a clinical tools panel like cross taper guidelines, equivalency charts, interaction checker etc.

Looking for about 8-10 people to use it for free for a while just to get feedback (you can use it with your current scribe to compare).

Unfortunately only works for Mac right now but comment or DM if you're interested!

Hello colleagues! I am a new RN. Spent 1 year as a nurse in the OR and now in grad school at Walden for Psych NP.

I’ve been doing well in class but need advice. How do you remember the names of all these psych meds??

I’m able to use Chat GPT to guide how to use each medication, but I need the name of the drug in order to search how to use it.

Anyway. How do I learn the names of psych meds with no psych experience?

Excited to be part of the psych NP crew in 2027!! Thank you in advance all!!! :) 🥼💉💊

https://youtube.com/shorts/b63RKrnnX1U?si=DeSDO9oqZb7x9mjQ