Specialties We Support

We provide tailored solutions for providers offering advanced psychiatric treatments, including:

✅Psychiatrists & Neurologists – Specializing in brain stimulation therapies and mood disorder treatments.
✅Pain Management Specialists – Treating chronic pain with Ketamine infusions.
✅Behavioral Health Clinics – Offering integrated mental health services, including TMS and Spravato.
✅Ketamine Therapy Providers – Clinics focusing on IV Ketamine infusions for depression and PTSD.
✅Outpatient TMS Centers – Dedicated facilities providing TMS treatments for psychiatric conditions.
✅Interventional Psychiatry Practices – Combining medication, neuromodulation, and psychotherapy.

All-in-One Practice Management for TMS, Ketamine & Spravato Therapy

1. Credentialing & Payer Enrollment

Credentialing for TMS, Ketamine, and Spravato providers is essential for insurance reimbursements and direct payer contracts. We simplify this process by:

✅Medicare, Medicaid & Private Insurance Enrollment
✅Spravato REMS Program Assistance
✅Specialty Provider Contracting for TMS & IV Ketamine Clinics
✅EDI, ERA, EFT Enrollment for Faster Payments
✅Re-Credentialing & Ongoing Compliance Management

2. Medical Billing & Coding for TMS, Ketamine & Spravato

Reimbursement for neuromodulation and advanced psychiatric treatments requires accurate coding, proper documentation, and prior authorization to avoid denials. We handle:

✅TMS Therapy Billing (CPT 90867, 90868, 90869)
✅Ketamine Infusion Therapy Billing (HCPCS J3490, S0013)
✅Spravato Nasal Spray Administration & Monitoring (HCPCS G2082, G2083)
✅Time-Based & Diagnosis-Specific Coding for Depression, PTSD & OCD
✅Prior Authorization & Medical Necessity Documentation
✅Appeals & Denial Management for Non-Covered Services

3. EHR/EMR Setup & Integration

TMS, Ketamine, and Spravato therapy require specialized EHR templates for accurate tracking of treatment progress, response rates, and compliance with REMS programs. We provide:

✅TMS & Neuromodulation-Specific EHR Integration
✅Ketamine Infusion Therapy Documentation Setup
✅Spravato REMS Compliance & Reporting Automation
✅Telehealth & e-Prescribing Integration for Psychiatry Practices
✅HIPAA-Compliant Patient Data Management

4. Compliance & Regulatory Support

Insurance coverage for TMS, Ketamine, and Spravato is subject to strict guidelines, medical necessity criteria, and ongoing documentation requirements. We ensure:

✅TMS & Spravato Compliance with Medicare & Commercial Payers
✅Ketamine Infusion Documentation for Off-Label Use Justifications
✅Spravato REMS Program Support & Patient Monitoring
✅HIPAA, MIPS, and MACRA Compliance for Psychiatry Practices
✅Audit Readiness & Risk Mitigation for Insurance Claims

5. Revenue Cycle Management & Practice Growth

Managing cash-based services like Ketamine alongside insurance-billed services like TMS & Spravato requires expert financial oversight. Our RCM solutions optimize revenue through:

✅Patient Eligibility Verification & Out-of-Pocket Cost Estimates
✅Insurance Contract Negotiation & Rate Optimization
✅Customized Billing Strategies for Hybrid Insurance & Self-Pay Models
✅Marketing & Referral Network Development for TMS & Ketamine Providers
✅Financial Performance Tracking & Revenue Growth Strategies

Types of Services Billed for TMS, Ketamine & Spravato

✅TMS Therapy (Transcranial Magnetic Stimulation)
→ Initial Treatment Planning & Mapping (CPT 90867)
→ TMS Treatment Sessions (CPT 90868)
→ Re-Evaluation & Adjustment of TMS Treatment (CPT 90869)
→ Treatment for Depression, OCD, Anxiety & PTSD
→ Multiple Treatment Session Billing for TMS Therapy Courses
✅Ketamine Infusion Therapy
→ IV Ketamine Infusions for Treatment-Resistant Depression (HCPCS J3490, S0013)
→ Pain Management Infusions for Chronic Pain & Neuropathic Conditions
→ Intramuscular (IM) & Intranasal Ketamine Administration
→ Monitoring & Observation Billing for Ketamine Therapy
✅Spravato (Esketamine) Therapy
→ Spravato Treatment Administration & Monitoring (HCPCS G2082, G2083)
→ Patient Supervision for Required 2-Hour Observation Period
→ REMS Compliance & Insurance Authorization Management
→ Long-Term Treatment Plan & Dose Optimization Support

Required Knowledge for Successful Billing & Compliance

1. Understanding Prior Authorization for TMS & Spravato

Many insurers require prior authorization for TMS and Spravato, with strict medical necessity criteria based on treatment-resistant depression history.

2. Ketamine Therapy & Off-Label Billing Challenges

Ketamine therapy is often not covered by insurance for psychiatric use, requiring a self-pay or hybrid model with proper documentation.

3. REMS Program Compliance for Spravato Therapy

Spravato is subject to Risk Evaluation & Mitigation Strategy (REMS) guidelines, requiring certified providers and detailed patient monitoring.

4. Correct Use of CPT & HCPCS Codes for TMS & Infusions

TMS requires procedure-based billing, while Ketamine and Spravato treatments follow drug administration coding with additional observation time tracking.

5. Maximizing Reimbursements for New & Emerging Therapies

Payer policies for neuromodulation and psychedelic-assisted therapies are evolving, requiring ongoing tracking of coverage updates and appeals for denied claims.

Why Choose Solubillix for TMS, Ketamine & Spravato Practice Management?

✔ Specialized Credentialing & Insurance Enrollment for Psychiatry & Neuromodulation Providers.
✔ Accurate Billing & Reimbursement Strategies for TMS, Ketamine & Spravato.
✔ End-to-End Revenue Cycle Management for Maximum Financial Growth.
✔ EHR/EMR Setup & Integration for Compliance & Efficient Documentation.
✔ Prior Authorization & REMS Compliance Support for TMS & Esketamine.
✔ Customized Solutions for Clinics Offering Self-Pay & Insurance-Based Models.

Start with Solubillix Today!

We ensure hassle-free credentialing, optimized billing, and streamlined compliance so you can focus on delivering life-changing treatments. Contact us today to learn how we can support your TMS, Ketamine, and Spravato practice!