Fractional Telepsychiatry for Hospitals

Psychiatric Expertise
When You Need It,
Not When It's Billable

Board-certified psychiatrists and NPs available remotely for your ED and inpatient units — without the cost of a 24-hour call retainer. We navigate California's 5150 hold and writ process so your team doesn't have to.

Board Certified Psychiatrists DMH Certified CA 5150 Specialists Licensed NPs
The Problem in Your ED
4–8 hrs
Average boarding time for behavioral health patients awaiting psychiatric evaluation — consuming ED beds, staff time, and throughput
The XpsyZ Difference
Fractional
Pay only for coverage you use. No expensive 24-hour retainer. No premium for geographic scarcity. Predictable, budgetable psychiatric access.
Your Revenue Advantage
+Billing
Your facility retains the ability to bill facility fees for psychiatric consult visits — turning a cost center into a revenue-generating service line
The Clinical & Operational Reality

Behavioral Health Patients Are Stalling Your ED

Every ED director knows the scene: a 5150 hold patient in Bay 4, a psych consult that won't arrive until morning, and a department grinding to a halt. Psychiatric access gaps aren't just a patient care problem — they're a throughput and financial crisis.

  • Boarding Delays Drive LWBS Rates Behavioral health patients boarding in ED beds block physical medicine capacity, inflate LWBS rates, and suppress patient satisfaction scores.
  • 📋
    5150 Hold Complexity Falls on Your Nurses California's involuntary hold and LPS conservatorship process requires expertise most ED nurses and hospitalists weren't trained to navigate — creating liability exposure.
  • 💸
    24-Hour Call Retainers Are Unsustainable Traditional psychiatric call coverage costs $30K–$60K/month for a single provider. Community hospitals and rural facilities simply can't compete for that talent or afford that model.
  • 🔍
    The Workforce Gap Is Structural California has among the worst psychiatrist-to-population ratios in the nation. Recruiting and retaining on-site psychiatric staff is a years-long, high-cost proposition.

"We built XpsyZ because we've both sat in the CMO chair watching behavioral health patients wait 12 hours in ED bays. We know exactly where the system breaks down — because we lived it."

Co-Founders — Both Former Chief Medical Officers
The XpsyZ Model

Deployed in Days, Not Months

A streamlined onboarding process built for hospitals that need rapid, compliant psychiatric access without renegotiating your entire staffing model.

01

Discovery & Credentialing

We assess your volume profile, EHR environment, and existing coverage gaps. Our providers initiate credentialing and privileging simultaneously — no waiting six months.

02

Coverage Architecture

We configure a fractional coverage schedule matched to your actual demand patterns — daytime, evenings, overnight, or surge-only. You pay for what you use.

03

Secure Platform Integration

HIPAA-compliant video consult platform integrates with your nursing workflow. ED nurses initiate consults; our psychiatrists are in view within minutes.

04

Documentation & Compliance

All documentation meets California DMH and CMS standards. 5150 and LPS writ documentation is handled by credentialed providers — full audit trail maintained.

Clinical Service Lines

What We Cover, Completely

Board-certified psychiatrists and licensed NPs available remotely for ED and inpatient behavioral health consults across the full acuity spectrum.

🚨

ED Psychiatric Evaluation

Real-time psychiatric assessment for patients presenting with acute behavioral health crisis, suicidality, psychosis, or altered mental status. Rapid consults initiated by nursing staff via secure video.

Emergency
📄

5150 Hold Management

Expert application, documentation, and release process for California WIC 5150 involuntary holds. We navigate the LPS conservatorship and writ process with full compliance — removing this burden from your clinical staff.

California Specialty
🏥

Inpatient Psychiatric Consult

Scheduled and urgent consult services for medical-surgical and ICU patients with comorbid psychiatric conditions — delirium management, medication adjustment, capacity evaluation, and disposition planning.

Inpatient
💊

Medication Management

Initial psychiatric medication orders, bridge prescribing for patients in medical holds, and psychotropic medication optimization for complex-comorbidity cases during inpatient stay.

Pharmacology
📊

Disposition & Placement

Psychiatric level-of-care determination, IMD placement coordination, step-down to outpatient, and aftercare planning — accelerating bed throughput by resolving the key bottleneck in behavioral health stays.

Throughput
🎓

Staff Education & Protocol Design

Custom behavioral health protocols, nursing education on psychiatric presentations, and 5150 documentation training. Building your team's capabilities alongside ours.

Operational
Why Fractional Works

The Economics Are Undeniable

Coverage Factor Traditional Model XpsyZ Fractional
Monthly Cost 24 hour retainer Pay for what you use
Recruitment Timeline 6–18 months 30–60 days
DMH Certification Not required Certified
5150 Documentation Your staff's problem Handled by us
Facility Fee Billing At risk ✓ Yes
Coverage Flexibility Fixed schedule Volume-matched
Geographic Availability Limited / rural gap Statewide remote
⚖️

Right-Sized to Your Volume

A 150-bed community hospital and a 400-bed regional medical center have different psychiatric demands. We configure coverage blocks to match — not a fixed 24-hour retainer that overpays for slow periods.

💰

Preserve Your Facility Fee Revenue

Psychiatric consult visits generate facility fee billing opportunity. Unlike independent contractor models, XpsyZ is structured to preserve your facility's ability to capture this revenue stream.

🔐

DMH Compliance Built In

All providers maintain active DMH designation. 5150 hold documentation is completed to California Department of Mental Health standards — protecting your facility from audit exposure and grievance vulnerability.

📈

Throughput as an Outcome

Faster psychiatric disposition directly reduces ED boarding time. Our CMO founders designed the service specifically to address this metric — because they measured it as hospital executives.

Certifications & Qualifications

Credentials That Clear the Bar

Every XpsyZ provider meets the credentialing requirements for California acute care facilities — without putting that burden on your medical staff office.

ABPN
Board Certification
All physician providers hold American Board of Psychiatry and Neurology (ABPN) certification. Nurse practitioners hold PMHNP certification from ANCC.
DMH
State Designation
California Department of Mental Health designated providers authorized to write and manage 5150 involuntary psychiatric holds and LPS conservatorship documentation.
CA
LPS 5150 Authorized
Full authorization under California Welfare & Institutions Code 5150. Experienced in the hold, writ, and appeal process — including coordination with county mental health and court systems.
HIPAA
Compliance Infrastructure
All consult technology operates on HIPAA-compliant, BAA-covered platforms. EHR integration, documentation standards, and data handling meet CMS CoP requirements.
CMS
Billing-Ready
Telehealth psychiatric services billed under CMS-approved codes. Facility fee structures preserved. Coding and documentation support for your revenue cycle team.
TJC
Accreditation Alignment
Provider credentialing packages are prepared to Joint Commission standards. Medical staff office receives a complete privileging file — accelerating approval timelines.
Leadership

Founded by Hospital Executives

XpsyZ wasn't built by venture capitalists or tech entrepreneurs. It was built by two Chief Medical Officers who inherited the problem — and refused to accept it as inevitable.

Co-Founder
Physician Executive
Chief Medical Officer · Clinical Lead

Extensive experience leading clinical operations at acute care facilities. Brings the clinical credibility and practical systems knowledge that differentiates XpsyZ from pure tech-enabled telehealth plays.

Co-Founder
Physician Executive
Former Chief Medical Officer · Operations Lead

Hospital executive with deep experience in ED throughput, behavioral health service line operations, and physician workforce strategy. Built the operational model for XpsyZ with one objective: solve the exact problem that plagued every ED under executive leadership. Knows where retainer models fail and where fractional coverage wins.

"The 5150 boarding problem isn't a clinical failure — it's a system design failure. Hospitals know they need psychiatric coverage; they just can't afford or access it in the traditional model. We built the model that didn't exist when we needed it."

XpsyZ Co-Founders

Let's Solve Your Coverage Gap

We work with ED Medical Directors, CMOs, CNOs, and hospital operations leaders. A discovery conversation takes 30 minutes and will give you a clear picture of what fractional psychiatric coverage would look like for your facility.

Serving California acute care hospitals, emergency departments, and behavioral health inpatient units
Coverage Statewide remote psychiatric services — no geography premium

Request a Discovery Call

Complete the form and a founder will respond within one business day.