PMHNP Clinical Triage & Statutory Compliance

Telehealth Psychiatric Triage & Medication Router

Standardized psychiatric clinical decision support for Advanced Practice Registered Nurses (APRN/PMHNP). Scores standardized DSM-5-TR validated screeners (PHQ-9, GAD-7), verifies Ryan Haight Act (21 U.S.C. § 829(e)) controlled substance restrictions, and models commercial insurance vs. out-of-pocket sliding scale costs.

Patient Physical State of Residence State Licensure

Primary Psychiatric Chief Complaint DSM-5-TR

PHQ-9 Depression Screener (0 = Not at all, 3 = Nearly every day)

Over the last 2 weeks, how often have you been bothered by these problems?

1. Little interest or pleasure in doing things

2. Feeling down, depressed, or hopeless

3. Trouble falling/staying asleep or sleeping too much

4. Feeling tired or having little energy

9. Thoughts of self-harm or being better off dead

GAD-7 Anxiety Cumulative Score (0–21) GAD-7

Current Medications & Requested Treatment Rx Screen

Clinical Triage & Prescribing Feasibility Result

Depression Severity (PHQ-9)

Moderate (Score 12)

Anxiety Severity (GAD-7)

Moderate (Score 11)

Estimated Cash-Pay Intake

$295 (CPT 99205)

Routine Med Management

$145 / 20-min session

Board-Certified Psychiatric APRN/PMHNP

Schedule Secure Video Intake Evaluation

Direct booking with licensed independent prescribers via HIPAA-compliant EHR portal.

Book Clinical Evaluation →

Clinical & Statutory Telehealth Prescribing Scope

1. Ryan Haight Act Controlled Substance Safeguards (21 U.S.C. § 829(e))

Federal law prohibits dispensing controlled substances (Schedule II stimulants like Adderall/Vyvanse, Schedule IV sedatives like Xanax/Klonopin) without at least one in-person medical evaluation, unless an authorized telemedicine special registration or active federal PHE extension waiver applies.

2. State Practice Authority Variations (AANP Standards)

              • Full Practice Authority (FPA: VT, ME, MA, NY, CO, WA): PMHNP independently evaluates, diagnoses, and prescribes.

              • Collaborative Practice (NC, SC, GA, FL, TX): Formal registered physician supervisory or collaborative agreement required.

3. Standardized DSM-5-TR Clinical Psychometrics

• PHQ-9 (0–27): 0–4 None, 5–9 Mild, 10–14 Moderate, 15–19 Moderately Severe, 20–27 Severe.
• GAD-7 (0–21): 0–4 Minimal, 5–9 Mild, 10–14 Moderate, 15–21 Severe Anxiety.

EMERGENCY CLINICAL NOTICE: 24/7 CRISIS PROTOCOL ACTIVATED

Telehealth Psychiatric Triage & Medication Router

Clinical & Statutory Telehealth Prescribing Scope

1. Ryan Haight Act Controlled Substance Safeguards (21 U.S.C. § 829(e))

2. State Practice Authority Variations (AANP Standards)

3. Standardized DSM-5-TR Clinical Psychometrics