Behavioral Health

Psychiatry and other physician-level behavioral health services are subject to CPOM in the same way as any physician specialty. A behavioral health company that employs psychiatrists or contracts with psychiatric practices must structure correctly in CPOM states. The physician PC must own the psychiatric practice entity. Non-physician behavioral health providers (LCSWs, LPCs, psychologists) have their own scope-of-practice rules that interact with the physician PC structure.

Telepsychiatry has grown significantly in recent years, driven by demand for psychiatric services and the availability of telehealth. Telepsychiatry platforms face the same multi-state CPOM issues as other telehealth platforms — CPOM compliance follows patient location. A telepsychiatry platform serving patients in California, New York, and Texas needs compliant physician PCs in all three states.

Psychiatric nurse practitioners (PMHNPs) and physician assistants providing behavioral health services have scope-of-practice rules that vary by state. In states requiring physician supervision of NPs (called 'collaboration' or 'supervision' depending on state law), the supervising physician and the supervision agreement must be compliant. The structure of supervision cannot be outsourced to the MSO — it must be documented within the physician PC framework.

Substance abuse treatment facilities face CPOM requirements and additional state-specific licensing requirements. Most states license substance abuse treatment programs separately from general medical licensing. This creates a compliance stack: CPOM-compliant physician entity PLUS substance abuse program license. New Jersey, in particular, has detailed behavioral health and substance abuse licensing requirements through the Division of Mental Health and Addiction Services.

Behavioral health group practices that include multiple provider types (psychiatrists, psychologists, therapists) require careful structuring. Psychologists and licensed therapists typically cannot be employed by a physician PC in their professional capacity — they often need their own professional entities. The MSO can provide shared services to multiple professional entities, but each entity must be properly owned and governed.