Therapy Billing Guides

Why Verification of Benefits Is Often Wrong

Why electronic and phone VOBs can miss deductible, network, authorization, Medicare, and Medicaid details before the first claim is processed.

CMS-1490S and Unenrolled Medicare Providers

CMS-1490S is a patient-submitted Medicare claim path. It does not turn an unenrolled therapist into a reimbursable Medicare provider claim.

Set Up Evernorth EFT

How Evernorth providers set up EFT and ERA, grant biller access, verify bank/payment routing, and reconcile remittance reports.

Idaho Medicaid Credentialing

A plain-English map of Idaho Medicaid enrollment, TPA/Gainwell, Magellan/IBHP, CAQH, Availity, and dual-plan exceptions for therapists.

Create an Idaho Medicaid TPA Account

What an Idaho Medicaid Trading Partner Account is, which TPA type therapists usually need, and how it connects to enrollment.

Idaho Medicaid Biller Access

How Idaho therapy practices can associate a billing agent with a Medicaid TPA without sharing the provider login.

Give Your Biller Access to ProviderOne

How Washington therapy practices can add a biller to ProviderOne with named users, profiles, and no password sharing.

Verify Apple Health Eligibility

A Washington therapy-practice workflow for checking Apple Health eligibility, managed-care payer, FFS coverage, and claim route.

Availity for Idaho IBHP

How Idaho therapists should place Availity Essentials in the Magellan/IBHP workflow without confusing it with the state TPA.

Apple Health Claims: ProviderOne vs MCOs

How Washington therapists should route Apple Health claims between ProviderOne fee-for-service and managed-care plans.

Verify Idaho Medicaid Eligibility

A therapist-focused checklist for verifying Idaho Medicaid, IBHP, MMCP, and Idaho Medicaid Plus eligibility before billing.

Apple Health Prior Auth for Therapists

How to route Washington Apple Health prior authorization through ProviderOne or a managed-care plan for therapy services.

Idaho Medicaid Claims Routing

How Idaho therapists should route Medicaid claims among Magellan, Gainwell, Molina, and UnitedHealthcare after eligibility verification.

Apple Health Telehealth Billing for Therapists

Washington Apple Health telehealth billing guide for therapists: HCA policy, mental health services, audio-only, and MCO checks.

Idaho IBHP Prior Authorizations

How therapists should check Idaho IBHP prior authorization requirements without assuming every therapy visit has the same rule.

Idaho Medicaid Telehealth Billing

A practical checklist for Idaho Medicaid telehealth billing across state, IBHP, and dual-plan workflows.

Idaho Medicaid Denials and Appeals

How Idaho therapists should classify Medicaid denials before deciding on correction, review, reconsideration, dispute, or appeal.

Idaho Medicaid Plus and MMCP

How Idaho therapists should handle dual-plan Medicaid members whose behavioral-health workflow may not follow standard IBHP routing.

Idaho YES for Child Therapists

A provider-facing map of Idaho YES, Magellan/IBHP, Liberty assessments, authorizations, and claim routing for child therapists.

Idaho WITS Sunset 2026

A time-sensitive checklist for Idaho SUD providers moving off WITS in July-October 2026.

Virginia Medicaid Credentialing for Therapists

How MES, PRSS, Cardinal Care, and MCO contracting fit together for Virginia therapists.

Access Virginia Medicaid MES and PRSS

How therapists use MES and PRSS provider portal access for enrollment, maintenance, eligibility, claims, and records.

PRSS vs Cardinal Care MCO Credentialing

Why Virginia Medicaid PRSS enrollment and Cardinal Care MCO credentialing are separate steps.

Verify Virginia Medicaid Eligibility

How Virginia therapists should verify Medicaid eligibility, Cardinal Care plan assignment, and claim lane.

Virginia Medicaid Claims for Therapists

How Virginia therapists route Medicaid claims between fee-for-service and Cardinal Care MCOs.

Virginia Medicaid Service Authorizations

How Acentra, Atrezzo, MES, and Cardinal Care MCOs fit into Virginia Medicaid behavioral health authorizations.

Virginia Medicaid Telehealth Billing

What Virginia therapists should check before billing Medicaid telehealth services.

Virginia Medicaid Behavioral Health and ARTS

A billing and credentialing map for Virginia Medicaid mental health and ARTS providers.

Virginia Behavioral Health Redesign

What Virginia Medicaid’s behavioral health redesign delay means for CMHRS and therapy providers.

Cardinal Care MCO Credentialing

How therapists should approach Virginia Cardinal Care MCO contracting and participation checks.

TennCare Medicaid ID vs MCO Credentialing

The Tennessee credentialing mistake that delays therapy claims: confusing a TennCare Medicaid ID with managed-care network participation.

Set Up TennCare Online Services

How Tennessee therapy practices should use TennCare Online Services / Interchange for eligibility and transaction workflows.

TennCare Biller Access

How a Tennessee provider should give a biller separate TennCare Online Services staff access instead of sharing an administrator password.

Verify TennCare Eligibility

A practical eligibility checklist for Tennessee therapists seeing TennCare members, including date span, MCO assignment, and claim routing.

TennCare Claims for Therapists

How Tennessee therapists should think about TennCare MCO claims, crossover claims, Online Services, and claim-route verification.

Verify Michigan Medicaid Eligibility

Learn how Michigan therapists should verify Medicaid eligibility, Benefit Plan IDs, MHP assignment, and TPL before sessions.

TennCare Telehealth Billing for Therapists

How Tennessee therapists should verify TennCare telehealth billing rules across state guidance, MCO policies, eligibility, and claim routing.

Michigan Medicaid Claims for Therapists

A practical guide to Michigan Medicaid claim routing for therapists: fee-for-service, Medicaid Health Plans, PIHPs, and CHAMPS.

TennCare Behavioral Health for Therapists

How Tennessee therapists should understand TennCare behavioral health routing, MCO assignment, Health Link context, and network checks.

Michigan Medicaid Prior Authorization

Learn how Michigan Medicaid prior authorization works in CHAMPS and what behavioral health providers should verify first.

Michigan Medicaid Telemedicine Billing

A practical Michigan Medicaid telemedicine billing guide for therapists covering audio-visual, audio-only, modifiers, and verification steps.

Michigan Medicaid Behavioral Health Routing

Learn how Michigan Medicaid behavioral health routing works across Medicaid Health Plans, PIHPs, and CMHSPs.

UHC Community Plan Tennessee Credentialing

What Tennessee therapists should verify for UnitedHealthcare Community Plan of Tennessee credentialing, behavioral health, authorization, and claims.

Oregon Medicaid Credentialing for Therapists

How OHP enrollment, the MMIS Provider Portal, Open Card, and CCO credentialing fit together for Oregon therapists — the plain-English map.

Enroll in Oregon Medicaid as a Therapist

A practical guide to OHP provider enrollment for therapists: what to gather, where the online request lives, and why CCO steps come afterward.

Create an Oregon Medicaid MMIS Account

How therapists set up Oregon Medicaid MMIS Provider Portal access after OHP enrollment — the PIN letter, supported browsers, and what the portal does.

Give Your Biller Access to Oregon MMIS

How Oregon Medicaid Provider Portal access works: add your biller as a clerk under the site administrator, and never share your login.

OHP Enrollment vs CCO Credentialing

OHP enrollment and CCO credentialing are not the same. Learn the difference before seeing Oregon Medicaid clients.

Verify OHP Eligibility Every Session

OHP eligibility is more than active coverage. Learn how Oregon therapists check CCO enrollment, Open Card status, and claim routing.

Oregon Medicaid Claims: Open Card vs CCO

When do therapists bill OHA/Open Card vs a CCO? A claims-routing guide for Oregon Medicaid — payer ID ORDHS, the portal, EDI, and why the lane matters.

OHP Prior Authorizations for Therapists

A practical guide to Oregon Medicaid prior authorization for therapists — when routine outpatient therapy needs PA, and OHA vs. CCO routing.

OHP Telehealth Billing for Therapists

Oregon OHP telehealth billing for therapists under OAR 410-120-1990: consent, licensure, POS 02 vs POS 10, and modifier 95 vs modifier 93.

OHP Billing Change for BH Associates

OHA is changing OHP Medicaid billing rules for board-registered behavioral health associates. Learn the July 1, 2027 date and what to verify.

Lane County OHP: PacificSource to Trillium

PacificSource no longer serves as a Lane County OHP CCO. What providers should verify now for Trillium — eligibility, claims, authorizations, contracting.

CareOregon / Health Share Credentialing

What therapists should know about CareOregon/Health Share provider contracting, OHP Medicaid IDs, and CareOregon Connect before applying.

Ohio Medicaid Credentialing for Therapists

How ODM enrollment, the PNM portal, centralized credentialing, and per-MCO contracting fit together for Ohio therapists — the plain-English map.

Give Your Biller Access to Ohio Medicaid PNM

How to delegate Ohio Medicaid PNM access to a biller or billing partner the safe way: add them as an Agent under their own OH|ID, not by sharing your login.

Verify Ohio Medicaid Eligibility Each Session

How to check Ohio Medicaid eligibility in PNM and identify which MCO, OhioRISE, or FFS a member is in — before every session — to avoid denials.

Ohio Medicaid Claims: FFS vs Managed Care

How Ohio Medicaid claims route: fee-for-service through PNM vs managed care through each plan, behind one EDI front door (OMES / Gainwell).

Prior Auth for Ohio Medicaid Therapists

How prior authorization works across Ohio Medicaid FFS, each MCO, and OhioRISE — plus the 2026 CMS-0057-F rules and standardized BH/SUD PA forms.

Ohio Medicaid Telehealth Billing Guide

How Ohio Medicaid covers telehealth therapy under OAC 5160-1-18 (effective 1/1/2026): place of service, the GT modifier, U-modifiers, and 2025-2026 codes.

Ohio Medicaid License Tiers for Therapists

Independent (LPCC/LISW/IMFT) vs dependent (LPC/LSW/MFT) — who can enroll with Ohio Medicaid and bill, and who needs supervision.

Ohio Medicaid 2026: BH Prior-Auth Changes

What Ohio's 2026 behavioral health prior-authorization changes mean for therapy practices and billers.

UMR Is Moving Optum Pay Payments to Zelis

UMR-administered plans are moving provider payments off Optum Pay and onto Zelis, which can default you into a virtual card that skims 2–3% per payment.

UMR Pays Through Zelis: Avoid the 3% Fee

UMR routes provider payments through Zelis, often as virtual cards or fee-based EFT that skim 2–3%. You're entitled to no-fee standard ACH EFT instead.

How to Add Bomi as Your Biller in TherapyNotes

A step-by-step guide to giving Bomi billing access to your TherapyNotes account by adding us as a Practice Biller user.

Meritain Health & Echo Health: Avoid 3% Fee

Meritain Health (an Aetna company) routes payments through Echo Health / QuicRemit as virtual cards that skim 2–3%. Switch to no-fee standard ACH EFT.

Echo Health (QuicRemit): Avoid the 3% Fee

ECHO Health pays many claims as QuicRemit virtual cards that skim 2–3%. Federal law gives you the right to no-fee standard ACH EFT — here's how to opt out.

HealthLink & Zelis: Avoid the 3% Card Fee

HealthLink routes payments through Zelis as virtual cards or fee-based EFT that skim 2–3%. You're entitled to no-fee standard ACH EFT instead.

Allegiance & Zelis: Avoid the 3% Card Fee

Allegiance routes payments through Zelis as virtual cards or fee-based EFT that skim 2–3%. You're entitled to no-fee standard ACH EFT instead.

Auxiant & Zelis: Avoid the 3% Card Fee

Auxiant routes payments through Zelis as virtual cards or fee-based EFT that skim 2–3%. You're entitled to no-fee standard ACH EFT instead.

Quest Behavioral Health & Zelis: 3% Fee

Quest Behavioral Health routes payments through Zelis as virtual cards or fee-based EFT that skim 2–3%. Switch to no-fee standard ACH EFT.

Zelis Skims 3% — Switch to No-Fee EFT

Zelis sends many insurance payments as virtual cards or fee-based EFT that skim 2–3%. Federal law gives you the right to no-fee standard ACH EFT instead.

Insurance Virtual Cards: Switch to EFT

Payers send therapy payments as single-use virtual cards that skim a ~3% fee. Here's how to get reissued as a check and enroll in EFT direct deposit.

Out-of-Network Billing for Therapists

Whether you can bill a payer you're not paneled with, and your client's options: out-of-network benefits, a superbill, a single-case agreement, or self-pay.

Medicare Incident-To & Supervised Billing

Why Medicare generally won't let you bill a pre-licensed therapist's psychotherapy under a supervisor like commercial payers do — and what to do instead.

UnitedHealthcare (UHC) Supervised Billing

How UnitedHealthcare (UHC) handles supervised billing for pre-licensed therapists — the most restrictive major commercial payer, and contract-dependent.

Aetna Supervised Billing for Supervisees

How Aetna handles supervised (supervisory) billing for provisionally- and pre-licensed therapists, and why roster contracting is often the cleaner path.

Cigna Supervised Billing for Supervisees

How Cigna handles supervised billing for pre-licensed therapists — billing a supervisee's sessions under a credentialed supervisor as the rendering provider.

Good Faith Estimates & the No Surprises Act

What the No Surprises Act requires of therapists: who needs a Good Faith Estimate, what it must include, and why it clears you to bill self-pay.

Add Bomi as Your Biller in SimplePractice

A step-by-step guide to giving Bomi billing access to your SimplePractice account by adding us as a Practice Biller team member.

BCBSIL Pass-Through & Trainee Billing NPIs

BCBSIL says licensed behavioral health providers should bill under their own rendering NPI, while qualifying trainee services may use a supervisor's NPI.

Counseling Compact in Indiana: Can You Bill?

The Counseling Compact is live in Indiana and Georgia. What Indiana LMHCs and group practices need to know about privileges, credentialing, and billing.

Add an Unregistered Biller to Virginia PRSS

How a Virginia Medicaid provider adds a first-time biller as an Unregistered Delegate in MES/PRSS.

Add a Registered Biller to Virginia PRSS

How a Virginia Medicaid provider adds an existing PRSS biller as a Registered Delegate using a last name and Relationship Code.

Mental Health CPT Codes: A Therapist's Guide

A plain-English lookup guide to common mental health CPT and HCPCS codes for therapists, including psychotherapy, testing, and telehealth.

Minnesota Medicaid Revalidation & Cash Flow

Minnesota's Medicaid revalidation shows how credentialing, enrollment, and documentation gaps become a cash-flow crisis for behavioral health providers.

Medicare Teletherapy Billing Rules in 2026

Medicare behavioral telehealth is more stable in 2026, but therapy practices still need clean POS codes, modifiers, and documentation for claims.

Illinois 90837 Rates Could Jump in 2027

Illinois HB1085 (Public Act 104-0446) sets a 2027 reimbursement floor for in-network mental health services. What therapists billing 90837 should know.

BCBSM Incident-to Billing: Michigan Groups

BCBSM and BCN are changing incident-to billing for commercial members. What Michigan therapy groups should review for rosters, NPIs, and modifiers.

Illinois HB1806: AI for Notes & Billing

Illinois HB1806 does not ban every AI tool in therapy practices. It separates administrative AI, documentation support, and AI that acts like the therapist.

BCBSNM and Lovelace Reach a New Deal

BCBSNM and Lovelace reached a new four-year agreement, avoiding a major New Mexico network disruption. What therapists and providers should note.

Therapy Platforms & the Reimbursement Squeeze

Alma, Aetna, Optum, and Headway reimbursement changes point to a trend: therapy platforms scale fast while payer contracts turn less favorable.

What's Going On With Alma, Aetna, and 90837?

Alma providers face an Aetna-related reimbursement change for CPT codes 90837 and 90834. Here's what is changing, what isn't, and what to document.

Best Medical Billing for Illinois Therapists

The best billing service for Illinois therapists owns the whole pipeline—credentialing, eligibility, claims, denials, and patient balances.

BCBSIL Behavioral Health UM Changes for 2026

BCBSIL's 2026 behavioral health update, tied to the Illinois Health Care Protection Act, changes utilization management rules for solo and group therapists.

BCBS IL: Use Medicaid ID for BCCHP Claims

As of February 1, 2026, BCBSIL says providers must use the Medicaid RIN instead of the subscriber ID on claims for BCCHP members, as required by HFS.