Everything a Psychology Practice Needs

Every state licenses psychologists through its own board, and each sets its own rules for supervised hours, examinations and jurisprudence. The national exam most boards rely on is the Examination for Professional Practice in Psychology (EPPP), administered by the Association of State and Provincial Psychology Boards (ASPPB) in two parts, Part 1 for knowledge and Part 2 for skills. A new license usually means official transcripts, verification of every license you have ever held sent directly from each board, exam scores, supervision attestations and a background check.

Where a board accepts applications only from the applicant, we prepare the complete application, line up every verification and tell you exactly what to submit and when, and then you submit it and check its status yourself.

If you plan to work in a state that is not part of PSYPACT, or you want in-person practice beyond what the compact allows, you still need a full license there. We build a plan that says which states need a license and which can be covered through the compact, and we track every renewal and continuing education cycle from one record.

The Psychology Interjurisdictional Compact (PSYPACT) gives psychologists two separate authorities. The Authority to Practice Interjurisdictional Telepsychology (APIT) covers telepsychology into other member states. The Temporary Authorization to Practice (TAP) covers temporary in-person, face-to-face practice in another member state for up to 30 days in a calendar year, based on notice to that state. Each one has its own ASPPB credential as a prerequisite: the E.Passport for telepsychology and the Interjurisdictional Practice Certificate (IPC) for temporary in-person work.

Both require a current, full and unrestricted license in a home state that belongs to the compact. For the E.Passport, ASPPB looks for a degree from a program accredited by the American Psychological Association or the Canadian Psychological Association, or a jointly designated program. For telepsychology under an E.Passport you must be physically present in your home state when you deliver services, and you renew each year, which includes continuing education on technology in psychology. The IPC and TAP must be renewed as well.

Under the compact, telepsychology happens where the client is located, and you are subject to that receiving state's scope of practice. The receiving state can limit or revoke your authority to practice there. The compact also does not apply in a state where you already hold a full license. Its current status is shown with the compact details on this page.

Medicare enrolls psychologists as clinical psychologists. To qualify you must hold a doctoral degree in psychology and be licensed or certified on the basis of that degree at the independent practice level in the state where you practice. Assignment is mandatory, so you accept Medicare's allowed amount as payment in full.

Your Medicare enrollment includes an agreement that, if the patient consents, you will attempt to consult with the patient's attending or primary care physician, and notify the physician if the attempt does not succeed. You document the patient's consent or refusal and the consultation or notice in the record. The only exception is when that physician referred the patient to you. Neither you nor the physician may bill for this required consultation.

Commercial plans, Medicare Advantage plans, Medicaid and Medicaid managed care plans each credential separately, and most rely on a complete, attested CAQH ProView profile. Some plans hand behavioral health to a separate company, so we confirm who actually credentials psychologists for each plan before we apply.

Psychological testing is billed in two parts. Test administration and scoring are reported with 96136 and 96137 when you do them, 96138 and 96139 when a technician does them, and 96146 for automated testing with automated results. Your evaluation work is a separate service reported with 96130 and 96131, or 96132 and 96133 for neuropsychological evaluation. Medicare contractor guidance says the record must document why the tests are being performed, that at least 31 minutes must be provided to report any per-hour code, and that testing spread over several days is combined and reported on the last day of service.

Psychotherapy codes are chosen by time. Contractor guidance tells you to pick the code closest to the actual time, not to report psychotherapy shorter than 16 minutes, and to document start and stop times or total time for 90832, 90834 and 90837. Crisis psychotherapy codes are based on total face-to-face time and are not reported with a diagnostic evaluation. When you add the interactive complexity code, the note must show the time spent on it.

Clinical psychologists cannot bill psychotherapy codes that include evaluation and management services. Services by your staff billed incident to your services require your direct personal supervision, with one exception: diagnostic psychological testing can be furnished under your general supervision.

For telepsychology, the license that matters is the one for the state where the client is during the session. A client who travels, or who moves after starting treatment, can put you outside your license or your PSYPACT authority without either of you noticing. We map where your clients are against your licenses and authorities and tell you when a gap appears.

Our telehealth platform runs HIPAA video visits that clients join from a browser with no app to install, and it is covered by a signed business associate agreement. Medicare's telehealth rules for behavioral health are shown in the callout here, with their current dates.

HIPAA gives psychotherapy notes their own protection. They are notes a mental health professional records to document or analyze the contents of a counseling session, kept separate from the rest of the record. They do not include medication prescribing and monitoring, session start and stop times, the type and frequency of treatment, test results, or summaries of diagnosis, symptoms, prognosis and progress. Those items belong in the regular record.

You need the patient's authorization for almost any use or disclosure of psychotherapy notes, with narrow exceptions such as your own use for treatment and defending yourself in a legal action the patient brings. Psychotherapy notes are also excluded from the patient's right of access. For the rest of the record, you must act on a patient's request for access within 30 days, with one 30-day extension if you explain the delay in writing.

Testing practices hold some of the most sensitive data a practice keeps: raw scores, protocols, reports and recordings. Our HIPAA program covers your security risk assessment, written policies, staff training, business associate agreements with every vendor, including testing and scoring platforms, and a breach response plan.

We set up the practice in the order that keeps you from waiting: entity formation coordinated with your attorney and accountant, an organizational NPI and tax registrations, malpractice coverage, then credentialing, because payer approvals take the longest. Your EHR, patient portal, telehealth and payment processing are configured and tested before your first client.

If you plan to see Medicare patients, add testing technicians or bring on postdoctoral fellows, we plan for it up front, because each of those changes how you enroll and bill. If you plan a cash-pay or out-of-network practice, we set up superbills through the patient portal so clients can seek reimbursement from their own plans.