Psychiatry billing in Quebec: 3 Things psychiatrists should know (+ checklist)

Key takeaways

1. Service determines your billing approach: Consultations, psychiatric therapy, reassessments, collateral interviews, and other psychiatric services have specific RAMQ codes and requirements.
2. Time-based services depend on accurately capturing time-based details: Psychiatric therapy codes can change according to session duration, making start and end times critical information.
3. Patient age and care settings likely change the applicable codes: RAMQ distinguishes between adult, child and adolescent, and geriatric psychiatry, while codes also vary between settings.
   

Psychiatry billing in Quebec depends on accurately capturing the type of service provided, where it took place, the encounter length, and other relevant details. Types of appointments, such as consultation or reassessment, follow different billing paths. Build your workflow around these distinctions to more easily select the right codes and identify billing issues.

Psychiatry demonstrates just how closely medical billing needs to follow the actual encounter.

A psychiatrist’s day may include initial assessments, follow-up visits, psychotherapy, medication management, family discussions, and other care across distinct care settings.

Each service creates its own billing considerations.

Thus, for Quebec psychiatrists, the challenge is less about memorizing every RAMQ code, and more about recognizing the common characteristics that determine the optimal billing pathway.

• Quebec physicians check their codes using the RAMQ Specialist Physician's Manual.

Here are three areas to focus on if you want to maximize your earnings as a psychiatrist.

1. Correct RAMQ codes depend on delivered services  

Psychiatry billing starts with a straightforward question:

What service occurred?

Was it a consultation? A main visit? A psychiatric reassessment? Individual therapy? Family therapy? Something else?

Differences between services matter, because RAMQ assigns distinct codes to specifics forms of psychiatric care.

And then duration forms another layer of distinction.

• For example, 08854 applies to outpatient, individual psychiatric therapy lasting a minimum of 35 minutes.
• For patients under 18, separate codes apply: 08973 for a minimum of 35 minutes and 08978 for 80 minutes or more.

This illustrates an important billing principle: the broad category of “psychiatric treatment” doesn't tell you enough to select the right code.

Billing tip: Identify the exact service first. Then confirm patient age, duration, location, and any other relevant code criteria.

2. Time and place change how care is billed 

Time-based billing is especially important in psychiatry.

For the psychiatric therapy codes shown in the RAMQ material, the service start time must

A strong note for a time-based psychiatric service should make it easy to establish:

• When the service started
• When it ended
• What type of intervention occurred
• Who participated
• 08971 during a short-term hospitalization
• 08799 in an emergency room
• 08932 in a long-term care hospital
• 08981 in an external setting

Moreover, place of service may change the billing code.

For example, the codes applied to consultations differ by setting:

RAMQ further distinguishes certain psychiatric services according to patient population. Separate codes appear for child and adolescent psychiatric consultations and gerontopsychiatric consultations in each of these environments.

So, a psychiatrist can't assume that a familiar service always maps to the same code everywhere.

In practice: Remember to add places of service to your code-selection routine before submitting claims.

3. Family, group, and third-party care require their own billing approaches  

Psychiatric care regularly involves people beyond the patient and psychiatrist.

This spans family members participating in treatment to group interventions within treatment plans.

RAMQ billing recognizes several of these situations, but each needs to meet its applicable requirements.

For example, family psychiatric therapy has dedicated billing codes based on session length:

• Code 08985 applies to family psychiatric therapy lasting a minimum of 35 minutes.
• Code 08992 applies to sessions lasting 80 minutes or more.
• These requirements make complete documentation especially important when psychiatric care involves multiple participants. A note stating only “family discussion” or “group therapy” may not contain enough information to support the service billed.

RAMQ also provides codes for interviews with a third party (defined as an interview with one or more people regarding the care of the same patient). Depending on the applicable billing schedule, codes such as 08986 or 08816 may apply.

Group psychiatric therapy carries additional requirements. For example, certain RAMQ group therapy codes require the health insurance number of each person participating in the service.

• These requirements make complete documentation especially important when psychiatric care involves multiple participants. A note stating only “family discussion” or “group therapy” may not contain enough information to support the service billed.

In practice: Capture participants, purpose, and timing while the encounter is fresh. Your future claims will be better for it.

Also see: 11 Medical billing terms Quebec physicians should know

Psychiatrist billing checklist 

Don't miss a step. Before submitting a psychiatry claim to RAMQ, confirm:

• The service performed matches the billing code selected.
• The correct place-of-service requirements have been applied.
• Patient age has been considered where child/adolescent or geriatric codes differ.
• Start and end times are recorded whenever the applicable code requires them.
• The clinical record supports the service and duration billed.
• Family, group, or third-party services identify the appropriate participants.
• Required patient health insurance information has been included.
• Supplementary or contextual billing requirements have been reviewed.
• The claim is consistent with the latest applicable RAMQ billing rules.

Build RAMQ billing around your psychiatry practice

Psychiatric care covers many types of encounters. Your billing workflow needs to keep pace with them.

Xacte by Petal combines specialized RAMQ billing technology with Quebec-based billing expertise.

• Physicians can use intelligent billing workflows and validation to identify potential issues while gaining access to a team that understands Quebec billing requirements.

When you spend less time fixing billing problems, both your patients and bottom line gain.

FAQs: Psychiatry billing in Quebec

How does psychiatry billing work in Quebec?

Quebec psychiatrists submit eligible medical services to RAMQ using the billing codes and requirements applicable to their practice, service type, patient, and care setting. Consultations, therapy, reassessments, third-party interviews, and other psychiatric services may use different codes.

Do psychiatrists need to record start and end times?

For certain time-based psychiatric services, yes. The RAMQ psychiatric therapy examples provided require the service start time for all listed therapy codes, with many also requiring an end time. Recording time accurately supports both claim submission and clinical documentation.

Are there different RAMQ codes for child psychiatry?

Yes. The RAMQ material includes dedicated codes for several child and adolescent psychiatric services, including therapy and consultations for patients aged 0 to 18. Verify the requirements attached to the specific service and care setting.

Does the location of a psychiatric service affect billing?

It can. The RAMQ schedules you provided show different psychiatry codes across short-term hospitalization, emergency, long-term care, and external settings. Physicians should verify the applicable place-of-service rules before selecting a code.

Can Quebec psychiatrists bill for interviews with family members or other third parties?

RAMQ schedules include codes for certain third-party interviews concerning a patient’s care. The applicable requirements need to be met, and the examples provided specify using the patient’s health insurance number rather than the third party’s.

Can psychiatrists bill for group or family psychiatric therapy?

RAMQ includes dedicated codes for certain group and family psychiatric therapy services. Eligibility and billing requirements vary according to factors including duration and participants, so physicians should verify the current RAMQ rules before submitting.