St. Louis Psychiatrist Psychotherapy Claims: Face-to-Face With an Absent Doctor

A St. Louis psychiatrist agreed to a $360,000 civil settlement over allegations of false face-to-face psychotherapy claims to Medicare and Missouri Medicaid. The government alleged that she billed as though she had personally provided the treatment while she was out of town or another practitioner had done the work. For someone inside the practice, the useful connection is between the clinician on the claim and the clinician who actually saw the patient.

The U.S. Attorney’s Office for the Eastern District of Missouri announced the settlement on March 9, 2026. The psychiatrist worked at Behavioral Health Services LLC, which owned and operated Psych Care Consultants in St. Louis.

Face-to-Face Claims for Another Practitioner’s Work

The government alleged that the psychiatrist falsely represented her own face-to-face psychotherapy services from January 1, 2019, through May 31, 2024. Its account identifies both claims submitted while she was out of town and claims for services other practitioners provided.

Those allegations put the identity of the treating clinician at the center of the case. A practice can have patients coming through the door and staff providing care while its claims still misrepresent who did the work. Here, the alleged substitution was specific: another practitioner’s service appeared as the psychiatrist’s own face-to-face psychotherapy.

We see the abuse of trust in that allegation. Medicare and Missouri Medicaid were being asked to pay for a personal encounter with a particular doctor, while the government’s account put that doctor elsewhere or credited another practitioner with the treatment. An absent doctor, present on the bill.

The records that explain that difference may sit with different people. A scheduler may know which clinician was away. A treating practitioner may know whose session it was. A biller may know which clinician appeared on the submitted claim. We connect those accounts to the dated service record, so the question becomes what the practice actually represented to the payer.

What a Psychotherapy Code Represents

Psychotherapy billing represents particular work by a particular practitioner, with time determining the choice of many codes. That gives an insider more to compare than a patient’s presence on an appointment list.

For example, First Coast’s Medicare coding instructions, revised effective January 1, 2025, place standalone psychotherapy code 90832 at 16 through 37 minutes, 90834 at 38 through 52 minutes, and 90837 at 53 minutes or more. The article requires start and stop times or total psychotherapy time. Time spent on a separate evaluation and management service is excluded from the psychotherapy time.

That distinction matters inside a psychiatry practice because a medical visit and psychotherapy can appear in the same patient’s billing. The treatment note has to explain the work behind the psychotherapy claim, rather than simply account for the patient’s entire visit. The clinician’s identity, the service and the time belong together.

Her Separate Civil Settlement

The psychiatrist’s agreement resolved False Claims Act allegations involving both Medicare and Missouri Medicaid. The Justice Department based the civil settlement on $155,000 for Medicare and $25,000 for Missouri Medicaid, doubled under the False Claims Act.

The investigation involved the combined work of the U.S. Attorney’s Office for the Eastern District of Missouri, HHS-OIG’s Office of Investigations, the Missouri Attorney General’s Medicaid Fraud Control Unit and the FBI.

Her Brother’s Separate Settlement

Her brother separately paid $501,556 under a July 2025 civil settlement, according to the later Justice Department announcement. He was a part-owner of Behavioral Health Services LLC. The government’s announcement of his agreement described similar allegations of face-to-face psychotherapy claims while he was out of town or other practitioners provided the services.

The shared practice makes his case relevant to workers who recognize the billing operation. Each agreement still concerns its own psychiatrist. We would trace the claim to the clinician it named and the work it represented, rather than treat the practice’s name as an answer to who supplied or billed the care.

When the Schedule and the Claim Tell Different Stories

In a separate whistleblower complaint involving Turning Point Care Center, the whistleblower alleged that doctors billed more patient time than they spent at the facility. In the Missouri case, the government’s allegation about an absent psychiatrist presents a related comparison between claimed personal treatment and where the clinician actually was.

How Much of a Settlement Does a Whistleblower Get?

A whistleblower case under the False Claims Act can pay the person who brings it 15 to 30 percent of what the government recovers. For someone who knows how psychotherapy claims were submitted, our work starts with the difference between the treatment the payer was charged for and what happened in the practice.

You Know Who Saw the Patient

If your practice’s claims name a psychiatrist who was away while someone else provided the care, speak with our whistleblower experts about the billing you know. We build the case with you around the claims, schedules and treatment records, and bring in behavioral health fraud whistleblower lawyers who understand psychotherapy billing. We stay beside you as your knowledge of the working day becomes the evidence behind the case.