Psychiatry Accounting Software

Accounting in a Psychiatry Practice

Psychiatric accounting used to be simple: visits in, payments out. Two changes made it harder. Interventional care brought drug costs, and groups added sites and separate entities. Unlimited Systems posts every payment, contractual adjustment and write-off as a double-entry line, so the ledger matches the billing record. Deposits from each payer are matched to posted 835s. When a practice buys Spravato for its own stock, each device is logged at purchase. The log is checked against the doses billed, whether that is J0013 by the milligram for a commercial plan or G2082 or G2083 for Medicare. A dose given but not billed shows up the same day, not at a physical count. Contract rates are checked against acquisition cost before the next order. Revenue and cost lines then export as standard journal entries, split by service line and Tax ID, for the corporate ledger.

Why Is Accounting Different in Psychiatry?

Most psychiatric revenue has no drug cost behind it. Therapy and E/M visits are pure professional fees. Spravato changed that for practices that buy and bill. The practice pays for each device up front, stores it as a Schedule III drug, and gets the cost back only when a claim pays. That is inventory accounting, and a visit-based ledger was never built for it.

The billing side makes the cost harder to follow. Each device holds 28 mg, so a 56 mg dose uses two devices and an 84 mg dose uses three. Commercial plans may pay per milligram under J0013. Medicare pays a G-code whose descriptor includes the dose itself. Some plans cover Spravato under the pharmacy benefit instead, and the drug arrives from a specialty pharmacy. The same treatment can carry a margin, a fixed bundle or no drug cost at all.

Structure adds a third layer. Many psychiatric groups run TMS or esketamine programs as their own service lines, and some place them in a separate entity with its own Tax ID. Therapy, medication management and collaborative care each have their own revenue pattern. Healthcare accounting in psychiatry has to keep those lines apart at close while still showing the whole group in one view.

What Psychiatry Accounting Software Handles

Spravato 28 mg devices

Each device delivers 28 mg, and doses are given as two or three devices. Purchases are logged by device, so stock on hand, doses given and doses billed reconcile. (FDA prescribing information: Spravato (esketamine) nasal spray, CIII)

J0013 for commercial plans

J0013 replaced S0013 for esketamine nasal spray and is billed per 1 mg. Units billed are checked against devices used, so an 84 mg dose bills as 84 units. (Janssen SPRAVATO Access, Coding and Reimbursement Guide (J0013 replaces S0013, 1 mg units))

G2082 and G2083 for Medicare

These G-codes cover the supervised visit and provision of esketamine, split at 56 mg. Because the dose sits inside the code, the ledger records drug cost against a bundled payment. (Federal Register: CY 2020 Physician Fee Schedule final rule, esketamine codes G2082 and G2083 (84 FR 62568))

Schedule III recordkeeping

Spravato is a Schedule III controlled substance. The device log that drives cost accounting sits beside the controlled substance records the practice already keeps. (21 CFR Part 1304: Records and reports of DEA registrants)

Payer rate versus acquisition cost

Contracted rates for J0013 are compared with the practice's purchase price. A rate below cost is flagged before more stock is ordered. (Janssen SPRAVATO Access, Coding and Reimbursement Guide (J0013 replaces S0013, 1 mg units))

TMS service line: 90867 to 90869

TMS planning, treatment and motor threshold codes post to their own revenue line in the journal export. The practice can then weigh TMS revenue against equipment cost in its own ledger. (CMS Billing and Coding Article A57647: Transcranial Magnetic Stimulation)

How Does Psychiatry Accounting Software Work?

1. 1. Post as double entry

   Payments, contractual adjustments and write-offs post as balanced journal lines. Each line traces back to posted ERA data and the claim it came from.

2. 2. Match deposits

   Deposits from medical plans, carve-outs and card batches are matched to posted payments. Unmatched cash is flagged for the finance team.

3. 3. Log drug purchases

   Spravato bought for stock is logged by device. That log is the starting point for drug cost.

4. 4. Reconcile doses to claims

   Doses given are checked against units billed every day. A dose with no claim, or a claim with no dose, is flagged.

5. 5. Check margin

   Contracted payment for each drug code is compared with acquisition cost. Low-margin payers are visible before the next order goes in.

6. 6. Export and close

   Revenue and cost lines export as standard GL journals, split by service line and Tax ID. Month-end starts from figures that already tie to billing.

Psychiatry Accounting Software vs. Generic Software

Who Uses It in a Psychiatry Practice

• Controller or CFO: Journal entries that tie to billing, by entity and service line, with deposits already matched.
• Practice owner: A real margin on Spravato and TMS by payer, next to service-line trends, before deciding to grow either program.
• Clinic manager: A daily list of doses that were given but not yet billed, so drug cost never sits unrecovered.