1. Forensic psychiatrists don't make big bucks seeing and treating patients in a treatment setting (i.e., forensic unit of a state hospital) and billing insurance. They do it by providing services like evaluation of compentency to stand trial, expert witnessing, etc., which are contracted out on a private basis and for which, if they have made a good name for themselves among lawyers and in the court system, they can charge hundreds of dollars per hour like lawyers can.
Let me clarify a bit. I am a forensic psychiatrist, fellowship trained. I see patients in an outpatient setting, under contract. I don't make bug bucks, but I can't complain.
Depending on the state, state hospitals and corrections can pay in the $240-280K/year range. These are state jobs and have pretty good benefits along with a lot of bureaucracy and paperwork. County jails usually pay a little less. A forensic fellowship is not required to work in a state hospital or corrections, but may open the door to more senior/supervisory roles at the institution.
I don't do competency evaluations. Usually, the court pays a set fee and psychologists and psychiatrists on a rotating panel perform the evals. The fee is about $200-$250 per eval. That entails travel to the jail, time to get into the jail through the sally port, time to have the inmate brought to the interview area, reviewing the records, interviewing the inmate, and writing the report. If you have to appear in court that may be part of the fee. The time to get into the jail may be minutes, or may be hours, or not at all if the jail is in lockdown. And, of course, taxes take about 1/3 off the top. I did the math: in my circumstances the net pay is slightly above minimum wage. I see a lot of competency evals on my patients, few are written by psychiatrists.
Most of the patients a forensic psychiatrist deals with are indigent. Rarely, a client can pay out of pocket. More prominent forensic psychiatrists can attract more clients that can pay out of pocket.
AFAIK, no forensic psychiatry services are covered by insurance.
How do some psychiatrists make more than others? They work harder and usually have more than 1 gig.