How to Start a PMHNP Private Practice

If you’re wondering how to start your own psychiatric mental health nurse practitioner (PMHNP) private practice, this article has tips and advice on starting a PMHNP private practice.

Starting a private practice as a psychiatric mental health nurse practitioner can be a lot of work. Not only do you need to manage the day-to-day tasks of being a clinician, but you also need to run a business.

If you are interested in the business side of running a PMHNP private practice, you’ve come to the right place.

In this article, we’ll go through the steps you need to know for starting a PMHNP private practice—from getting the licenses you need to legal pitfalls to avoid.

What do psychiatric nurse practitioners do? 

Nurse practitioners are advanced practice nurses with master’s or doctorate degrees who are able to assess, diagnose, and prescribe medications. 

There are many different specialties of nurse practitioners, including family nurse practitioners, acute care nurse practitioners, and psychiatric mental health nurse practitioners. 

As a psychiatric nurse practitioner, you are able to diagnose patients, prescribe medications, and provide psychotherapy. 

PMHNPs are able to work in hospital settings, correctional facilities, substance abuse clinics, schools, emergency rooms, inpatient psychiatric units, and outpatient mental health private practices. They can also start their own PMHNP private practice.

Nurse practitioners can complete health and physical assessments, and order laboratory and diagnostic tests like lab work and chest X-rays based on any physical assessment findings. 

Psychiatric mental health nurse practitioners also commonly collaborate with other physicians, physician associates, nurses, nurse practitioners, and other healthcare team members.

Steps for starting a PMHNP private practice

As with starting any wellness private practice, successfully starting a PMHNP private practice can be challenging. The key is learning everything you can—from billing and insurance to how to coordinate with your team. 

Here are some of the most important steps to follow to start a PMHNP private practice: 

1. Obtain a Board of Nursing license in the state you are looking to start your practice.
2. Buy or lease an office space or obtain a virtual address if you plan to conduct telepsychiatry. (You need this to register for an LLC!)
3. Determine your business name and start a limited liability company (LLC) or professional limited liability company (PLLC), depending on your state’s laws. You can use a service like LegalZoom or work with a certified public accountant to have this done.
4. Obtain your Controlled Dangerous Substances (CDS) license number (if necessary, per your state’s requirements).
5. Obtain your DEA number if you plan on prescribing controlled substances.
6. Obtain a furnishing license (if necessary, per your state).
7. Obtain a Type 2 NPI number.
8. Obtain malpractice insurance for your practice.
9. Open a business bank account for your practice.
10. If you will be accepting insurance, start the insurance credentialing process with insurance companies. If you will be cash pay only, you can skip this step.
11. Sign up for an electronic health record (EHR) that has all the features you need. For example, if you’ll be offering telehealth, choose a platform that integrates it into the platform.
12. Consult with a lawyer regarding anything business-related and your overall structure.Once you’ve completed the steps above, you can begin seeing patients and marketing your practice.

Here are some other tips for running your PMHNP private practice:

• Set up a phone number for your practice, and have a voicemail greeting to tell prospective patients to go to your website and request an appointment.
  
• On your website, have a request appointment form for prospective patients to fill out. When you have free time, you can review the request, verify the patient’s insurance, and see if you would like to take this patient. You can change these protocols in the future if you have time to answer phone calls or hire staff for an administrative role.
  
• In the beginning, make it simple! Have your EHR send new clients automated paperless intake forms to request insurance information, consent, and all the legal paperwork.

Come up with a psychiatric nurse practitioner private practice business plan

Creating a successful business requires you to come up with a plan that focuses on your target market, what you want to offer, and pricing strategies.

Starting a PMHNP private practice can require very little capital expenditure—whether you’re operating a telepsychiatry-based practice, have a physical location, or choose a hybrid model. 

The initial capital you have to spend will be on office supplies, your office space, furniture, computer, internet, and any professional learning or development courses.

The secret to success is hard work and perseverance. The hard work includes obtaining clients, improving clinical outcomes, stabilizing patients, and ultimately empowering them to live their best life.

When coming up with your PMHNP private practice business plan, reflect on the following questions:

• What are your short-term and long-term goals for opening a practice?
  
• Why did you start a private practice? Is it to make a lot of money? Is it to be able to give better healthcare to your patients? To have more flexibility to spend time with family? To work less? To have more autonomy?
  

• Make sure that you have a clear mission and value statement.
  
• Be specific about what kind of patient demographic you’re looking to target.

Whatever your reason for starting your own practice, these prompts will motivate you to become a successful practice owner.

Nurse practitioner private practice: Three legal pitfalls

While starting a private practice can be very rewarding, it can also come with significant legal risks as well. 

Here are three ways you can avoid legal pitfalls:

1. I always recommend consulting with a business lawyer to help create your business structure and protect yourselves from certain liabilities. They can also help you with creating intake forms, employee contracts and handbooks, privacy and HIPAA-compliance, and advise you on how to deal with subpoenas.
   
2. When looking for your first location, consult with a business lawyer to look over the contract, regardless if you are looking to lease or to buy. I have seen firsthand many PMHNPs who didn’t hire a lawyer and then got stuck in a five to seven year lease with no way to get out.
   
3. Many clients now opt for virtual care via telehealth, so it’s essential to stay up to date with today’s telehealth laws. Let’s say you have a PMHNP private practice in California. You are not permitted to see a patient residing in Pennsylvania or Virginia unless you also get your PMHNP license in that state. If your patient from California is temporarily on vacation in another state, you are also not allowed to see that patient virtually.

Choosing an EHR for psychiatric nurse practitioners

When deciding on the best EHR for psychiatric nurse practitioners, you’ll want to consider if it offers the following features:

• Does it have tailored intake and progress notes with psychiatry in mind?
• Does it have automated mental health screening tools?
• Can new and existing clients request appointments online?
• Can you automate appointment reminders to reduce no-shows and cancellations?
• Do you want a secure messaging system to communicate with clients?
• Is billing and insurance claim filing integrated into the system?
• Does the EHR have a mobile app that allows you to access your schedule on-the-go?
• Is there email, video, or chat support in place should you have questions?

How SimplePractice streamlines running your practice

SimplePractice is HIPAA-compliant practice management software with everything you need to run your practice built into the platform—from booking and scheduling to insurance and client billing.

If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.

Try SimplePractice free for 30 days. No credit card required.