Credentialing
Mental Health Credentialing Services for Therapists and Practices
Our mental health credentialing services (behavioral health credentialing services, in the plans' terms) enroll LCSWs, LMHCs, LMFTs, psychiatric nurse practitioners and psychiatrists with insurance plans' behavioral networks, Medicare and Florida Medicaid, solo or in groups. Since January 1, 2024, LMHCs and LMFTs can bill Medicare in their own name, at 75% of the physician fee schedule amount.
The short answer
What do mental health credentialing services cover?
Enrollment with every payer a therapist bills: the plans' behavioral networks (Lucet for Florida Blue, Evernorth for Cigna, Optum for UnitedHealthcare), Medicare, and Florida Medicaid, which enrolls therapists as provider type 07 only as a group or a group member. None of these payers credentials a registered intern. The Advixor Group prepares, submits and follows up each application, through each plan's participation agreement.
SourcesLucetEvernorth Behavioral HealthOptumAHCA Provider Enrollment Policys. 491.0045
Florida Licenses
Therapist credentialing, license by license
What each Florida license (chapter 491) and a psychiatric APRN enrolls as.
| License | Medicare enrolls it as | Medicare specialty · taxonomy | Florida Medicaid (with the license) |
|---|---|---|---|
| LCSW | Clinical social worker | 80 · 1041C0700X | Provider type 07 |
| LMHC | Mental health counselor | E2 · 101YM0800X | Provider type 07 |
| LMFT | Marriage and family therapist | E1 · 106H00000X | Provider type 07 |
| Psychiatric APRN | Nurse practitioner | 50 · 363LP0808X | Type 30, specialty 930; collaborative agreement (Form 5000-1067) unless autonomous |
| Registered intern | Not eligible | n/a | No intern provider type |
Sources CMS Claims Processing Manual, ch. 12, and taxonomy crosswalk (Aug 2026); AHCA Provider Enrollment Policy (Feb 2026).
Behavioral Networks
Insurance credentialing for therapists: what each behavioral network checks
Several plans run behavioral health through a separate network with its own application: Florida Blue through Lucet, Cigna through Evernorth Behavioral Health, and UnitedHealthcare through Optum. All three require a license to practice independently, as does Humana.
- Lucet (Florida Blue). At least 15 hours a week in practice, 24-hour phone coverage, electronic claims, and appointments within 7 days of a discharge or referral. Psychiatrists need ABMS or AOA board certification. Lucet’s rule for nurse practitioners names a collaborative agreement with an in-network psychiatrist or addiction medicine specialist, or autonomous licensure, and an ANCC psychiatric-mental health certification (or one from the International Nurses Society on Addictions).
- Evernorth Behavioral Health (Cigna). A CAQH ID; a CV (if used) dated within two years; five years of work history, with gaps over six months explained; a W-9 for each tax ID; and, for prescribers, a DEA registration at least 60 days from expiring. The online form can’t be saved: finish it in one sitting. Inside a Cigna-participating medical practice, therapists who take no community referrals join under the practice’s medical contract.
- Optum (UnitedHealthcare). Top causes of slowed or canceled applications: a CAQH profile that is incomplete, expired or out of line with the participation form’s locations; no CAQH authorization for United Behavioral Health; an unsigned W-9 or a wrong tax ID; slow replies to document requests.
Medicare
LCSW, LMHC and LMFT insurance credentialing with Medicare
Medicare needs three things from an LMHC or LMFT: a master’s or doctorate that qualifies for the license, 2 years or 3,000 hours of supervised clinical experience after the master’s, and a state license. Florida’s licenses already require the 2 years, so CMS asks for no extra proof.
“Effective January 1, 2024, MFTs and MHCs can bill Medicare independently for their services furnished for the diagnosis and treatment of mental illnesses.”
- The form. The paper CMS-855I (05/23 edition) has no MFT or MHC box: check “Undefined Non-Physician Practitioner Specialty” in Section 2H and write in MFT or MHC, or file in PECOS, which lists both. A revised 855I is pending; check the edition before mailing.
- Groups. Adding an LMHC or LMFT to a group that already bills Medicare for LCSWs keeps the group’s PTAN; the clinician gets a PTAN linked to the group.
LCSW, LMHC, LMFT and NP claims must be on assignment.
Sources CMS Claims Processing Manual, ch. 12, §§120, 150, 240, 250; 42 CFR 410.152(b)(4), 414.21, 414.56, 414.62.
Telehealth
Mental health credentialing for telehealth: what Medicare asks
Medicare’s in-person requirement for mental health telehealth does not apply through December 31, 2027. From 2028, a patient seen at home needs an in-person visit in the 6 months before the first telehealth service and within 12 months of each one after, with limited exceptions; if you aren’t available, a same-specialty clinician in your group can do it. Patients already on mental health telehealth at home by then count as established: they need only the 12-month visit.
Seeing patients only by telehealth from home? Enroll your home as a practice location marked “Home office for administrative/telehealth use only” to keep the street address off Care Compare. With a physical office, you don’t have to report your home.
Florida Medicaid
Behavioral health credentialing with Florida Medicaid
- No solo application. AHCA offers provider type 07, Specialized Therapeutic Services, only as a “sole proprietor enrolling as a member of a group” or as a group.
- Full or Limited. Full enrollment links you to a community behavioral health group (provider type 05). Limited enrollment, for joining Medicaid health plans’ networks, needs no link.
- Agencies. For fee-for-service Medicaid, therapy providers “must be either employed or contracted with a community behavioral health agency.” Health plans follow that policy unless their AHCA contract says otherwise.
- Site visits. A type 05 group is moderate risk: AHCA visits before initial enrollment and at every renewal, with the location operational and the applying provider present. Members must be enrolled type 07 practitioners or physicians, including a physician if the group provides medication or psychiatric services.
- Service limits. AHCA reinstated the community behavioral health and targeted case management service limits on October 14, 2026, waived since March 2022. For plan members, work out continuity of care with each plan.
- Directories. AHCA must test plan directories to confirm behavioral health providers are accepting enrollees (s. 409.967), so keep your status current with every plan.
Registered Interns
Credentialing for therapists who are still registered interns
Florida registers interns in all three professions under s. 491.0045: background screening, a supervision plan and a qualified supervisor. Experience before registering doesn’t count toward the license.
- $200The most the registration fee can be
- 60Months until a registration expires
- 12,257Registered interns in Florida in fiscal 2025-26
- 36,943Licensed clinicians the same year (in-state, active)
Sources s. 491.0045, Florida Statutes; Florida DOH, MQA Annual Report FY 2025-26, Table 1.
What’s included
What our mental health credentialing service includes
CAQH and NPI
Set up each clinician's CAQH profile, authorize each plan to view it, and keep it ready for re-attestation every 120 days.
Learn morePayer enrollment
Prepare, submit and follow up each plan and behavioral network application, through the participation agreement.
Learn moreMedicare enrollment
Prepare and submit each therapist's Medicare enrollment (CMS-855I), including reassignment to your group.
Learn moreFlorida Medicaid enrollment
Enroll each therapist with Florida Medicaid as provider type 07, then with the Medicaid health plans you choose.
Learn moreRecredentialing
Keep every enrollment current, from plan recredentialing to Florida Medicaid's renewal every 5 years.
Learn morePayer contracting
Help with each plan's participation agreement, from the application to negotiation support.
Learn moreQuick answers
Mental health credentialing services: what therapists ask before they start
Getting on panels, what a plan pays before your effective date, timelines, malpractice coverage, Medicaid IDs and Medicare's fee. Ask us about your own case in a consultation.
How do I get on insurance panels as an LCSW, LMHC or LMFT?
Will a plan pay for sessions I see before I'm credentialed?
How long does therapist credentialing take?
Do therapists need malpractice insurance to get credentialed?
Does a behavioral health group need a separate Medicaid ID for each office?
Is there a Medicare application fee for LMHCs and LMFTs?
Talk to an advisor
You care for patients. Who’s taking care of the business?
Tell us where your practice is today. We will tell you what we would do first.
Official sources
All read October 17–19, 2026.
- CMS: MFT and MHC page and enrollment FAQs; Claims Processing Manual, ch. 12; Benefit Policy Manual, ch. 15; Telehealth FAQ; taxonomy crosswalk
- 42 CFR 410.26, 410.53, 410.54, 410.73, 410.152, part 414, subpart B, part 424, subpart P
- Florida Statutes s. 491.005, s. 491.0045, s. 409.967; chapters 627 and 641
- AHCA: Provider Enrollment Policy; Behavioral Health Therapy Services Coverage Policy; alert on service limits
- Florida DOH: MQA Annual Report FY 2025-26, Table 1
- Plans: Lucet; Evernorth Behavioral Health; Optum and its 2026–2027 credentialing plan; Humana policy