How to Launch a Solo PMHNP Private Practice: Checklist

Timeline at a glance

Work backward from your launch date. Credentialing is almost always the slowest step, so it starts earliest. The months below are a rough planning guide, not a guarantee. Payer timelines vary widely by state and plan.

1. Entity, EIN and bank account

Set up the business before you sign contracts. Payers, banks and vendors will ask for the legal name and tax ID you use.

• Choose a business structure (sole proprietor, LLC/PLLC, corporation). Ask a local attorney or CPA whether your state requires a professional entity type for licensed clinicians and how each choice affects your taxes.
• Register the entity with your state and get an Employer Identification Number (EIN) from the IRS. The IRS issues EINs for free; apply on irs.gov and avoid paid look-alike sites.
• Open a separate business bank account and card. Keep practice income and expenses out of personal accounts from day one.
• Decide who keeps the books (you, software or a bookkeeper) and set aside money for quarterly estimated taxes.

Official sources: SBA: choose a business structure · IRS: get an EIN

2. Malpractice insurance

Payers and platforms ask for a certificate of insurance before they credential you, so get this early.

• Get quotes for an individual professional liability policy that covers your license type, telehealth and every state where you will see patients.
• Check payer minimums before you buy. For example, Alma requires $1 million per claim and $3 million aggregate for its insurance program (Alma). Most commercial payers publish their own minimums in their credentialing requirements.
• Ask about claims-made vs. occurrence coverage, tail coverage if you leave an employer policy, and whether prescribing controlled substances changes the premium.
• Save the certificate as a PDF. You will upload it to CAQH and every payer application.

3. NPI, CAQH, state license and DEA

These are the identifiers every payer and pharmacy will ask for. Rules vary by state, especially for nurse practitioner practice authority and controlled-substance registration, so confirm each one with the official source for your state.

• NPI. Get or update your individual (Type 1) NPI in NPPES. If you will bill under your entity, ask your biller or payers whether you also need an organization (Type 2) NPI. Update your practice address and taxonomy when you move.
• CAQH. CAQH has rebranded as DataSpring. Most commercial payers pull your credentialing data from the CAQH Provider Data Portal, so complete your profile, upload documents and authorize the payers you apply to. DataSpring says profiles are kept current on a 120-day attestation cycle, so put re-attestation on your calendar (DataSpring for clinicians; portal login).
• State license and practice authority. Hold an active, unrestricted license in each state where your patients are located. Whether you need a collaborative or supervisory agreement with a physician depends on your state and sometimes on your practice hours. Check your board of nursing (NCSBN board directory) and the AANP state practice environment map.
• DEA and state controlled-substance registration. If you will prescribe controlled substances, apply for DEA registration for each state where you prescribe (DEA Diversion Control registration). Many states require a separate state controlled-substance registration first, and most require you to register with the state prescription monitoring program (PDMP). Your board of nursing or board of pharmacy will say which applies.
• Telehealth prescribing. DEA and HHS have extended the COVID-era telemedicine flexibilities for prescribing controlled medications through December 31, 2026 (DEA announcement). Plan for the rules to change after that, and follow your state's rules too.
• Medicare. If you will see Medicare patients, enroll (or decide to opt out) through PECOS. See CMS provider enrollment.

4. Insurance credentialing

Getting in-network with each insurer is the longest step. Start 4–6 months before you want to bill insurance. Some payers move in weeks, and others take much longer.

• Pick 3–5 target payers based on who your local patients use and which plans have open panels for psychiatric NPs in your area.
• Apply through each payer's provider portal or credentialing application, pointing it to your CAQH profile. Keep a tracker: payer, date submitted, reference number, contact, next follow-up date.
• Follow up every 1–2 weeks by phone or portal message, and log every call with a reference number.
• When approved, get the signed contract, your effective date and the fee schedule in writing. Do not bill that payer for dates of service before the effective date.
• Enroll in electronic remittance (ERA) and direct deposit (EFT) with each payer, usually through the payer's portal or your clearinghouse.
• Need patients before contracts arrive? You can see cash-pay patients, or use an insurance platform as a bridge while you credential directly. See our guide to leaving Headway, Alma, Grow or Rula.

From the directory: Availity Essentials. Availity is a free multi-payer portal for eligibility and authorizations

5. Choose an EHR

For a prescriber, the EHR decision mostly comes down to e-prescribing: electronic prescribing of controlled substances (EPCS), PDMP access, and what those add-ons really cost.

• List must-haves: EPCS and PDMP if you prescribe controlled substances, telehealth, insurance claims, intake forms, a patient portal and psychiatric note templates.
• Total the real monthly cost: base plan + ePrescribe/EPCS + AI notes + telehealth + per-claim fees.
• Examples from our listings: PracticeQ (IntakeQ) Practice Management is $84.90/mo with eRx priced separately; SimplePractice ePrescribe is a $49/mo add-on plus $89 setup; TherapyNotes ePrescribe is $65/prescriber/mo with controlled substances at no extra fee; ICANotes prices by prescribing level with built-in EPCS and PDMP. Confirm current pricing with each vendor.
• Confirm the BAA covers the exact plan and add-ons you will use, and get data-export terms in writing before you sign.
• If you want AI help with notes, Blueprint is priced per session (reported $0.99/session with your EHR). Get patient consent for recording and review every note before you sign it.

Compare: Best EHR for solo psychiatry & PMHNP practices · How to choose an EHR · All EHRs.

6. Clearinghouse and billing

A clearinghouse sends your claims to payers and returns remittances. Many EHRs include one, or connect to one, so decide on the EHR first.

• Ask your EHR which clearinghouse it uses or integrates with natively, what it charges per claim, and whether eligibility checks and ERAs are included. Our listings show, for example, SimplePractice claims from $0.39/claim and TherapyNotes $0.14 per claim, ERA and eligibility check (third-party reviews).
• Open the clearinghouse account in your practice's name and keep the admin login. If you hire a biller later, give them their own user account rather than handing over yours.
• Doing your own billing at first? Block a weekly time slot for claims, denials and patient balances, and learn your top 5 CPT codes and payer rules well.
• Collect patient balances with a card-on-file authorization and a clear financial policy. For uninsured or self-pay patients, the No Surprises Act generally requires a Good Faith Estimate on request or when care is scheduled at least 3 business days ahead (CMS).
• Use free payer tools for prior authorizations before paying for automation: CoverMyMeds is free to providers.

More: Billing & prior auth tools · Prior auth AI tools.

7. Telehealth and HIPAA basics

As a covered entity you need written agreements with vendors that handle patient data, and a documented security risk assessment.

• BAAs. Sign a business associate agreement with every vendor that creates, receives, stores or transmits PHI for you: EHR, telehealth, email, phone, intake forms, AI tools, billing. HHS publishes sample BAA provisions.
• Security risk assessment. The HIPAA Security Rule requires a risk assessment. The free HHS/ONC SRA Tool is built for small and medium practices. Redo it when you add systems or locations.
• Telehealth. Use a telehealth platform covered by a BAA (often built into your EHR). Confirm you are licensed in the state where the patient is physically located for each visit.
• Email and AI. Use a paid Google Workspace or Microsoft 365 plan with the BAA accepted, or encrypted email such as Paubox. Never paste patient details into consumer AI chat tools. BastionGPT is a HIPAA-oriented AI assistant with a signed BAA (vendor site) for drafting letters and admin text.
• Website tracking. Keep ad-tracking pixels off booking, intake and portal pages. HHS has warned that tracking technologies can disclose PHI (HHS OCR bulletin; note a 2024 court order vacated part of that guidance).
• Write basic policies: Notice of Privacy Practices, device and password rules, breach response, and who has access to what.

From the directory: Google Workspace + Gemini, Paubox, BastionGPT. See also AI tools with a BAA

8. Website and Google Business Profile

Most patients will check your website and Google listing before they call.

• Build a simple site: who you treat, services (evaluations, medication management, telehealth), insurance accepted, self-pay rates, location or states served, and how to book.
• Claim your free Google Business Profile and add your hours, services and booking link. Add Google Search Console (free) to see what people search to find you.
• Don't collect clinical details through an ordinary website contact form. Send people to a HIPAA-enabled intake form or booking page instead.
• A website chatbot can answer FAQs and take appointment requests after hours. Chat Data offers a BAA on its Standard plan ($95/mo) and above (vendor site); keep a person responsible for replies.

More: Marketing tools · Marketing implementation guide.

9. Intake and scheduling

Get forms, consents and phone coverage in place so new patients can book without phone tag.

• Build digital intake: demographics, insurance card, history, screening measures, consents (treatment, telehealth, financial policy, card-on-file). Jotform (HIPAA) supports HIPAA forms on its Gold or Enterprise plans after you enable HIPAA and sign the BAA; IntakeQ includes a BAA and pairs with PracticeQ.
• Send forms automatically when someone books, with reminders, so they are done before the first visit.
• Set up online scheduling with clear visit types (initial evaluation, follow-up) and buffer time for documentation.
• Plan phone coverage. A missed call is often a lost patient. AI receptionists can answer, book and take messages: MedReception AI lists a self-serve Studio plan at $299/mo with a BAA for PHI deployments; Central is reported at $89/mo for 90 calls and books on Cal.com, Calendly or Google Calendar. Route urgent or clinical calls to a human.
• Write your cancellation and no-show policy, prescription-refill policy and after-hours crisis instructions (for example 988) before you open.

Compare: AI receptionists for small practices · Intake tools · Phone & scheduling tools.

10. Marketing

Early on, listings and referral relationships usually matter more than ads.

• Complete your profiles in payer directories and on Psychology Today Directory (therapist profiles from $29.95/mo per its join page; confirm pricing for prescriber listings).
• Introduce yourself to local therapists, primary care offices and pediatricians who need a prescriber to refer to. A one-page referral sheet with your intake process and insurance list helps.
• Ask satisfied patients for reviews in a compliant way, and never reply to a review with patient details.
• Answer every inquiry quickly, the same day if you can.
• Track where each new patient heard about you so you know what to keep paying for.

Launch week and the first 90 days

• Book a test patient (a colleague) end to end: booking, intake, telehealth, e-prescribe in test mode, note, claim, payment.
• Submit your first claims and watch them daily until the first ERA arrives. Fix rejections fast.
• Re-check every payer's effective date before you see that payer's patients.
• Review weekly: new inquiries, show rate, claims submitted vs. paid, denials, and hours spent on admin.
• At 90 days, decide what to automate or hand off first (billing, phones or intake).