Therapist credentialing
Mental health credentialing services for therapists and counselors
We get therapists, counselors, social workers and psychologists on insurance panels. We set up CAQH, apply to the payers that fit your practice, follow up until you have an effective date and send you a status update every week. Credentialing starts at $80 per payer.
- LPC, LMHC, LCSW, LMFT and psychologist credentialing
- Medicare enrollment for counselors and MFTs
- 5 commercial payers free with billing
Who we credential
Credentialing for every type of licensed therapist
We credential independently licensed mental health clinicians in solo and group practices. Each license type has its own payer rules, and we know which ones apply.
LPC and LMHC
Licensed professional and mental health counselors. Most commercial payers credential them, and Medicare now enrolls them as mental health counselors.
LCSW
Licensed clinical social workers are credentialed by most commercial payers and have long been able to enroll in Medicare.
LMFT
Licensed marriage and family therapists. Commercial coverage is common, and Medicare now enrolls them as marriage and family therapists.
Psychologists
Psychologists are credentialed by commercial payers, Medicare and Medicaid, including for testing services where the payer covers them.
Payers generally credential clinicians who hold an independent license. Associate or pre-licensed clinicians usually cannot be credentialed on their own; rules vary by payer and state.
Getting paneled
How therapists get on insurance panels
Getting paneled means a payer has credentialed you and signed a contract with an effective date. We run each step for you.
- 01
Pick the right payers
We look at which plans your clients carry and which networks are open in your area, then agree the list with you.
- 02
NPI and CAQH
We confirm your NPI and taxonomy, then build or update your CAQH ProView profile and authorize each payer to view it.
- 03
Applications
We submit complete applications, including to behavioral health networks that some health plans use for mental health.
- 04
Follow-up
We check with each payer on a schedule, answer their questions and send you a written update every week.
- 05
Contract and effective date
We review the participation agreement with you, confirm your effective date and provider ID, and tell you when you can bill as in-network.
Medicare
Medicare now enrolls counselors and marriage and family therapists
Since January 1, 2024, Medicare pays marriage and family therapists and mental health counselors, including many LPCs and LMHCs, for services to Medicare patients.
Before 2024, LPCs and LMFTs could not bill Medicare directly. They can now enroll through PECOS as individual practitioners and reassign benefits to their group practice. LCSWs and psychologists could already enroll.
Medicare has its own education, licensure and supervised-experience requirements. We check that you qualify, complete the enrollment and make sure your claims go out under the right provider type.
Medicare rules change. We confirm current CMS requirements before each enrollment.
Closed panels
What we do when a panel is closed or full
A closed panel is not always a final answer. Payers limit networks where they already have enough providers, but they still need clinicians who fill gaps.
- We ask the payer about exceptions and point to what makes you needed: a specialty, a population you serve, Spanish or another language, telehealth availability or evening hours
- We apply in nearby counties or states where you are licensed and the network is open
- We look at the behavioral health network behind the plan, which may have different openings
- We track the payer and reapply when the network reopens
- We tell you plainly when a payer is not worth chasing, so you can focus on the ones that are
No one can guarantee a closed panel will accept a provider. We tell you the realistic options for each payer.
Groups and solo practices
Individual versus group credentialing
Every clinician is credentialed as an individual. A group practice is also contracted as a group, and each clinician is linked to it.
Moving from solo to a group, or from one group to another, usually means updating your enrollments rather than starting over. We handle the changes so claims keep paying.
| Solo practice | Group practice | |
|---|---|---|
| NPI | Type 1 NPI for the clinician | Type 1 NPI for each clinician plus a Type 2 NPI for the group |
| Tax ID on claims | Often the clinician’s own EIN or SSN | The group’s EIN |
| Payer contract | Individual contract | Group contract; each clinician is added to it |
| Adding a new clinician | Not applicable | Credential and link the new clinician to the group before they bill |
Pricing
Therapist credentialing from $80 per payer
Pay per payer, choose a package, or use a monthly plan. When you use our billing service, we credential 5 commercial payers free. Medicare and Medicaid are priced separately.
Common questions
Can LPCs and LMFTs bill Medicare?
Yes, since January 1, 2024. Medicare now covers services by marriage and family therapists and mental health counselors, which includes many LPCs and LMHCs. You must meet Medicare’s requirements and enroll through PECOS first.
How long does it take a therapist to get paneled?
As a general range, commercial payers commonly take about 60 to 120 days from a complete application to an effective date, and some take longer. We follow up on a schedule and update you every week.
What if an insurance panel is closed?
We ask the payer about exceptions based on what makes you needed, such as a specialty, language or telehealth availability. We also look at nearby areas, the plan’s behavioral health network and reapplying when the panel opens. No one can guarantee acceptance.
Can associate or pre-licensed therapists be credentialed?
Usually not on their own. Most payers credential only independently licensed clinicians. A few payers and states have supervised billing arrangements, and we check the rules for your situation.
Should I credential as an individual or as a group?
Every clinician is credentialed individually. If you have or plan to have more than one clinician under one tax ID, a group contract with a Type 2 NPI usually makes adding clinicians and billing simpler.
How much does therapist credentialing cost?
Credentialing starts at $80 per payer, with packages and monthly plans available. With our billing service, 5 commercial payers are credentialed free.
Guides from our team
Learn more before you decide
How to Get Paneled With Insurance as a Therapist: Steps, Timeline and Cost
How to get in-network with insurance as a therapist or counselor: what you need, how long it takes, what it costs, and what to do if a panel is closed.
Read the guide →Can LPCs and LMFTs Bill Medicare? How Counselors and MFTs Enroll
Since 2024, LPCs and LMFTs can enroll in Medicare. Who qualifies, how to enroll through PECOS, and how Medicare pays counselors and MFTs.
Read the guide →Optum Behavioral Health (UnitedHealthcare): Credentialing and Billing for Mental Health Providers
How to join Optum’s behavioral health network for UnitedHealthcare members, why UHC medical credentialing is not enough, and Optum denials.
Read the guide →Find out what your claims are leaving on the table
Tell us about your practice. We will review 90 days of claims and show you what is recoverable, at no cost.
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