Counselor Credentialing for LCSWs, LPCs and LMFTs

Medtransic handles counselor credentialing for licensed clinical social workers (LCSWs), professional counselors (LPCs) and marriage and family therapists (LMFTs), solo or in a group. We match your NPI record to your license, keep your CAQH profile attested, enroll you in Medicare and file every commercial application. It costs $150 per application, per provider. In our experience it usually takes 60 to 90 days with each payer. You can follow every application and its stage in your client portal.

Last reviewed 2026-10-04.

Where counselor applications get stuck

Several of these rules are new since 2024. Others run the opposite way to what most owners expect.

  1. A profession that reads differently on each record

    Since January 1, 2024, Medicare has had its own specialty types for marriage and family therapists and mental health counselors. Your NPI taxonomy, your Medicare enrollment and your commercial applications all need to name the same profession. Checking that they agree is the first thing we do.

  2. Supervisee sessions billed under the licensed clinician

    Many owners assume an LCSW or LPC can bill an associate's sessions under their own Medicare number. Medicare does not cover services billed incident to an LCSW, an MFT or a mental health counselor. The licensed clinician can only be the one working incident to a physician, clinical psychologist, nurse practitioner or certain other practitioners.

  3. A compact privilege a payer may not accept

    A Counseling Compact privilege is equivalent to a license in the other state. Whether a payer will let you use it is a separate question. The compact itself tells counselors to check with their insurance company before applying.

  4. A privilege that runs out at license renewal

    A compact privilege expires on the same date as the home-state license it was issued under. Renewing the license does not move that date. The privilege has to be renewed on its own in CompactConnect.

  5. Hiring around the Social Work Compact too early

    More than 30 states have enacted the Social Work Licensure Compact, and it has reached activation. No multistate licenses are being issued yet, and the compact says that will take 12 to 24 months. Until then, an LCSW cannot use it to see clients in another state.

Who handles what on a counselor's file

What we run

What stays with you

Your EHR shows what you billed. Your portal shows what we are doing about it.

Your EHR or practice management system runs your practice, but it does not show you our work. The Medtransic HIPAA Compliant Portal does: every claim and its current stage, the denials we are working, your A/R by age, each payer application and its in-network date, and the documents we still need from you. It is the same record our team works from, and it comes with every client account.

Did that claim get paid?

Every claim with its stage and amount, the denials we're working, and your receivables by age.

Where is my application with Aetna?

Each payer application shows its stage, its history, and the date you can start seeing that payer's patients.

What do you still need from me?

One list of the documents we're waiting on. Upload once, and it reaches every payer that asked for it.

It works in any browser, on your desk or your phone. iPhone and Android apps are coming soon. See the client portal.

Medicare for LCSWs, LPCs and LMFTs

Medicare now enrolls all three license types. These rules are from CMS and are current as of October 2026.

LPCs and LMFTs, since January 1, 2024. Marriage and family therapists and mental health counselors can bill Medicare on their own for diagnosing and treating mental illness. The counselor category covers licensed mental health counselors, clinical professional counselors and professional counselors. Addiction counselors and alcohol and drug counselors who meet the same requirements can enroll as mental health counselors.

What Medicare requires. An LMFT or counselor needs a master's or doctorate that qualifies for the state license, at least 2 years or 3,000 hours of supervised clinical experience after the master's, and a state license or certification. An LCSW needs a social work master's or doctorate, at least 2 years of supervised clinical social work, and a state license or certification.

What Medicare pays. All three are paid 75% of the fee schedule amount Medicare pays a clinical psychologist for the same service. All three must accept assignment.

Where the work can happen. LMFTs and counselors can treat Medicare patients by telehealth. Their services to skilled nursing facility residents are excluded from the facility's consolidated billing, so they bill Part B directly with the facility's Medicare provider number on the claim. Psychologists, LCSWs, LMFTs and counselors can all bill Medicare's monthly behavioral health integration service when they do the work personally.

What the LCSW benefit leaves out. Medicare does not pay LCSWs under their own benefit for hospital inpatient services. The same goes for partial hospitalization or intensive outpatient work at a hospital outpatient department or community mental health center. Some work with skilled nursing and dialysis facility patients is excluded too, when it falls under the facility's own participation requirements.

How we credential a counselor, start to finish

We run these steps for each clinician, so every payer sees the same name, the same license and the same profession.

  1. NPI record checked first

    Before anything is filed, we check the taxonomy on your NPI record. It has to match the license: clinical social worker, professional or mental health counselor, or marriage and family therapist.

  2. CAQH profile built and kept attested

    We load your license, malpractice cover and work history into your CAQH profile. Then we keep the attestation current, so the profile is ready whenever a payer reads it.

  3. Medicare, once you qualify

    CMS lists the steps as an Identity & Access account, an NPI, Medicare's enrollment application in PECOS, and working with your Medicare contractor. Medicare enrolls MFTs, counselors and social workers only once they are licensed and have finished their supervised hours. We file as soon as you meet both.

  4. Commercial and behavioral health networks

    We file with each payer you choose and follow up until there is a decision. How separate behavioral health networks and closed panels work is covered on our behavioral health credentialing page.

  5. Tracked in your client portal

    Each application shows its stage in your client portal, with any document we still need from you. The portal is included with every client account.

The Counseling Compact application must be completed and submitted by the counselor. Employers, credentialing companies and other representatives may not legally do it for you. Once your privilege is issued, we handle payer enrollment for that state.

Before you add a state or an associate

The Counseling Compact is live in 10 states

As of October 1, 2026, counselors can get privileges in Arizona, Arkansas, Georgia, Indiana, Louisiana, Minnesota, Ohio, Oklahoma, Tennessee and Wyoming. Oklahoma went live that day. Another 29 states and DC are completing the steps to issue and accept privileges.

Who can get a privilege

Only counselors licensed in and living in a live state can apply, and recent graduates still completing supervised hours are not eligible. A privilege can be issued in minutes. Fees vary by state; the compact's own example uses Ohio's initial fee of $55 per privilege.

Associates and Medicare

Medicare enrolls MFTs, counselors and social workers only once they are licensed and have finished their supervised hours. An associate's work can be billed incident to a physician, psychologist or nurse practitioner under general supervision, which means the supervisor can be reached by phone rather than on site. Every other incident-to rule still applies, including an initial service by the billing practitioner, and incident-to billing is not allowed in hospitals or skilled nursing facilities.

Associates under commercial plans: one example

Optum publishes a reimbursement policy for supervised services by pre-licensed clinicians under its commercial behavioral health plans, effective October 1, 2024. It does not apply to Medicare or Medicaid plans or to ABA, and in most states it covers only network groups with a participation agreement signed by September 30, 2024. Other payers set their own rules, so we check each one before an associate goes on the schedule.

When counselor credentialing can wait

If you are still an associate, Medicare will not enroll you until you are licensed and your supervised hours are done. Come back when the license is issued.

If every client pays you directly and you do not plan to join any panels, you do not need credentialing. If you later want billing as well, we bill inside SimplePractice, TherapyNotes and the other systems therapists use, at 4-8% of what we collect for you.

Questions counselors and therapists ask about credentialing

Can LPCs and LMFTs bill Medicare?

Yes. Since January 1, 2024, licensed marriage and family therapists and mental health counselors, including professional counselors, can enroll and bill Medicare directly. Medicare pays them 75% of what it pays a clinical psychologist, and they must accept assignment.

How much does Medicare pay an LCSW?

The same share: 75% of the fee schedule amount for clinical psychologists. LCSWs must accept assignment too.

Can I bill my associate's sessions under my license?

Not in Medicare, which does not cover services billed incident to an LCSW, MFT or mental health counselor. Commercial payers set their own rules; Optum, for example, publishes a supervision policy for its commercial behavioral health plans. We check each payer before you schedule an associate.

Can Medtransic apply for my Counseling Compact privilege?

No. The compact requires the counselor to complete and submit the application personally. Once you hold the privilege, we file your payer enrollment for that state.

Can LCSWs use the Social Work Licensure Compact yet?

Not yet. The compact has reached activation and more than 30 states have enacted it, but multistate licenses are not being issued. Clinical social workers will need an accredited MSW or higher, the qualifying national exam, and 3,000 hours or 2 years of supervised clinical practice.

How long does counselor credentialing take, and what does it cost?

In our experience it usually takes 60 to 90 days with each payer. Medtransic charges $150 per application, per provider, and there is no long-term contract.

Sources

Outside facts on this page were checked against these sources on the date shown.

Related pages

Book a free revenue audit

We look at a sample of your actual claims and show you, line by line, where money is going uncollected. No commitment follows it. Call (888) 777-0860 or book a free revenue audit.