American Psychiatric Centers / Comprehensive Psychiatric Services: Psychotherapy Add-Ons for Allegedly Absent or Insufficiently Documented Therapy

American Psychiatric Centers, doing business as Comprehensive Psychiatric Services, agreed to pay $2.75 million in a fraud case over alleged psychotherapy add-on billing for services its providers had not delivered or sufficiently documented. For clinicians and billing staff, the case turns on a familiar distinction: what the patient received, what the chart describes and what the organization charged.

The company, headquartered in Walnut Creek, provides behavioral medicine services to individuals and families in California. The Justice Department announced the False Claims Act settlement on August 19, 2025.

What 90833 and 90836 Represent

Codes 90833 and 90836 represent psychotherapy delivered alongside a separately identifiable evaluation and management service. The combined claim tells the payer that the clinician performed both kinds of work.

Psychotherapy has its own billing requirements. The extra code carries a specific claim about treatment beyond the medical part of the encounter, and about the time spent providing it. That is the distinction behind the government’s allegations against Comprehensive Psychiatric Services.

The Medicare contractor First Coast Service Options explains the time component in its psychotherapy billing guidance, revised effective January 2025. Under that guidance, 90833 covers 16 through 37 minutes of psychotherapy with an evaluation and management service. Code 90836 covers 38 through 52 minutes. Those are psychotherapy minutes, with the evaluation and management time excluded.

The same guidance recognizes that psychotherapy need not occupy one continuous stretch of a combined visit. The documentation still needs to show the psychotherapy time, through start and stop times or a total, and identify the services separately. Counting the entire appointment as psychotherapy would erase the distinction the add-on is supposed to preserve.

Wisconsin Physicians Service, another Medicare contractor, explains the medical side in its psychiatry billing guidance, revised effective January 2026. When psychotherapy accompanies the visit, the evaluation and management level is selected through medical decision-making. Time spent on that work is excluded from the psychotherapy time. Both parts have to stand on the work they represent.

What the Government Alleged About Comprehensive Psychiatric Services

The government alleged that the company used the psychotherapy add-ons from January 1, 2015 through December 31, 2022 when its providers either had not performed the services described by the codes or had not sufficiently documented them. The allegation reaches both the care and the record offered to support the bill.

For the unprovided-service allegation, the question is what psychotherapy the patient actually received. For the documentation allegation, the question is whether the clinical record supports the psychotherapy charged. Keeping those questions separate matters to a clinician who remembers the encounter and to a billing employee who sees the claim after the visit.

First Coast’s guidance makes the relationship between the chart and the charge concrete: the submitted procedure code must describe the service performed, and the medical record must carry the responsible practitioner’s signature. For a combined visit, the documentation must distinguish the psychotherapy from the evaluation and management work. A visit appearing on the schedule answers only part of the billing question.

We see the problem in what the extra code asks the public to buy. The government pays for another service, and the provider needs to be able to account for that service. Adding a code does not add care.

The Civil Settlement and the Agencies Behind It

Comprehensive Psychiatric Services agreed to resolve the government’s False Claims Act allegations through a civil payment allocated between the United States and California. Of the settlement, $2,615,569 was allocated to the United States and $134,431 to California.

The Justice Department’s announcement credits the U.S. Attorney’s Office for the Northern District of California, the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse, and federal investigators with the coordinated investigation and settlement.

That agency mix reflects the reach of government-funded health care. The announcement specifically discusses TRICARE, veterans’ healthcare programs and the Federal Employees Health Benefits Program. An allegation about psychotherapy billing can concern the same clinical service across several public programs.

A Therapy Visit Can Become a Different Claim

The amended whistleblower complaint against Turning Point Care Center and Universal Health Services alleged that a psychotherapy session was billed as psychotherapy plus a medical service, while the Comprehensive Psychiatric Services allegations concern the psychotherapy component of a combined claim.

In Mindpath Care Centers North Carolina’s settlement, the government alleged that psychotherapy and medication-management claims from 2018 through 2020 lacked documentation of separate, distinct psychotherapy despite repeated employee concerns.

What Evidence Does a Whistleblower Need?

We work with you to assess the gap between the psychotherapy billed and the care delivered, including what the treatment notes and claimed time show. A clinician may know which work occurred during the encounter. Someone in billing may know how that encounter became a claim.

A treatment note can explain the work described, a claim can show the services charged, and your account can explain where they diverged. The distinction between psychotherapy that was not delivered and psychotherapy that was not sufficiently documented shapes the case we build.

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Know What Happened During the Visit

If psychotherapy appeared on the bill but you know the visit or its documentation told a different story, speak to one of our Whistleblower Experts about psychotherapy billing. We build your strongest psychotherapy billing whistleblower case with you, bring in healthcare fraud whistleblower lawyers who understand psychiatric billing, and remain your partners as the case moves forward.