Physician documentation, Current Procedural Terminology (CPT) coding, and compliance with federal billing regulations are essential given the government's significant efforts to address fraud and abuse and the grave financial and legal consequences of noncompliance. Because Medicare guidelines do not focus substantially on psychiatric care, compliance is especially challenging for psychiatrists and psychiatric centers. Four years ago, the University of Texas-Harris County Psychiatric Center formed a medical staff coding committee to assist the center and its psychiatrists in dealing with compliance issues. The committee has evolved into a highly effective and important component of the institution's overall compliance program. The authors discuss the origins, development, and accomplishments of the medical staff coding committee.