Credentialing for licensed psychologists and psychology groups
Psychologist Credentialing for Medicare and Insurance Panels
Medtransic handles psychologist credentialing for solo psychologists and psychology groups. We set up your NPI records and CAQH profile, enroll you in Medicare under the right psychologist type, and file and chase every commercial and behavioral health network application. It costs $150 per application, per provider. In our experience it usually takes 60 to 90 days with each payer. You see every application and its stage in your client portal, and there is no long-term contract.
How a psychologist's file is built
Illustrative- 1
NPI records
Matched to your license and Medicare type
- 2
CAQH profile
Re-attested every 120 days
- 3
Medicare in PECOS
For you, and your group if you bill as one
- 4
Commercial networks
Filed and followed up to a decision
- 5
Effective date
Recorded in your client portal
- Credentialing
- $150
- per application, per provider
- Typical time
- 60-90 days
- with each payer, in our experience
- Tracking
- Live
- every application and its stage in your portal
- Contract
- None
- no long-term contract
What holds up a psychologist's application
Most delays come from a few avoidable mistakes, each tied to a published rule.
Enrolled as the wrong Medicare psychologist type
One of Medicare's two psychologist types bills only diagnostic tests a physician or practitioner ordered. A doctoral psychologist with an independent license placed there cannot bill therapy.
A lapsed CAQH attestation
Commercial payers read your CAQH profile, which must be re-attested every 120 days (180 in Illinois). A lapsed profile can leave an application sitting.
A group that wants only some plans
Aetna says every participating provider in a group must meet its criteria and join all plans in the group agreement. A group cannot pick one product.
Clients in another state
PSYPACT can cover the license, with a separate ASPPB certificate for each kind of authorization. Aetna also requires malpractice cover in every state where care is given.
Who does what on a psychologist's file
Medtransic runs
- Matching your NPI record, CAQH profile and applications
- Building your CAQH profile and re-attesting it on schedule
- Medicare enrollment in PECOS, for you and your group if you bill as one
- Commercial and behavioral health applications, followed up to a decision
- Effective dates and documents we still need, in your client portal
- Re-credentialing when you move, add a location or add a psychologist
Your practice keeps
- Your license, renewals and continuing education
- Your malpractice policy and its limits
- Signing the applications and agreements
- Deciding which payers you want to join
Two ways to enroll in Medicare as a psychologist
This choice is made on the enrollment application, and it decides what you can bill.
Clinical psychologist
You hold a psychology doctorate and an independent-level license based on it. You can bill treatment and testing, at the full fee schedule rate only if you accept assignment.
Independently practicing psychologist
You are not a clinical psychologist and practice free of an employer's control. You bill only diagnostic tests a physician or certain practitioners order, naming them on the claim.
What the type means for testing staff
Staff can give tests under a clinical psychologist's general supervision, so you need not be in the room. An independently practicing psychologist must give the tests personally.
Your signature carries a promise
Signing the enrollment form is how a clinical psychologist agrees to the rule on consulting the patient's primary care doctor. Neither of you can bill Medicare or the patient for that consultation.
How we get a psychologist in network
We run these steps for each psychologist, in this order.
NPI records that match
NPIs are free; we check your NPPES description, "Psychologist" or "Psychologist, Clinical", matches your license and Medicare type.
CAQH profile built and current
We load your license, malpractice and work history into your free CAQH profile and re-attest every 120 days (180 in Illinois).
Medicare enrollment, individual and group
You enroll in PECOS as a non-physician practitioner, and a practice billing as a group also files Medicare's group application.
Commercial and behavioral health networks
We check each payer's published criteria, file, and follow up until there is a decision.
PSYPACT, for clients elsewhere
The APIT covers telepsychology and the TAP covers in-person work up to 30 calendar days a year per state; neither adds you to a network.
More than 40 states have passed PSYPACT laws, including Alaska and Iowa in 2026; Iowa's takes effect July 1, 2027. Check the PSYPACT map for the states in effect today.
What payers look for in a psychologist
Each payer checks something different; these are the published rules we file against.
| Payer | What it requires | Worth knowing |
|---|---|---|
| Medicare | A psychology doctorate and an independent-level license in your state, for the clinical psychologist type. | Without both, the only psychologist route is the testing-only type. |
| Evernorth (Cigna) | A license to practice independently, without supervision, in the state where you provide services. | Re-attestation every 120 days. Joining can take up to 90 calendar days. |
| Aetna | Malpractice cover at your state's required amounts, or the amount typical for your region if the state sets none. | In a group, every participating provider meets the criteria and joins all plans in the agreement. |
| Every commercial payer | A complete, attested CAQH profile. | We keep yours attested so it is current whenever a payer reads it. |
Your client portal, included
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.
When you may not need us yet
- If you are a postdoc or not yet licensed at the independent level, there is little to file. Come back when the license is issued.
- If your practice is entirely self-pay and you plan to join no panels, you do not need credentialing.
- If you only want billing, see psychology billing. We bill inside SimplePractice, TherapyNotes and other systems, at 4-8% of what we collect for you.
Questions psychologists ask about credentialing
How much does psychologist credentialing cost?
Medtransic charges $150 per application, per provider. Your NPI and your CAQH profile are free. There is no long-term contract.
How long does psychologist credentialing take?
In our experience it usually takes 60 to 90 days with each payer. Payers publish their own timelines; Evernorth, for example, says up to 90 calendar days.
Should I enroll in Medicare as a clinical psychologist or an independently practicing psychologist?
With a psychology doctorate and an independent-level license based on it, the clinical psychologist type lets you bill treatment and testing. The independently practicing type bills only diagnostic tests that a physician or practitioner ordered.
Can a psychometrist give tests under my Medicare enrollment?
Yes, if you are enrolled as a clinical psychologist. Medicare allows testing by staff under your general supervision, so you do not have to be present. Commercial plans set their own rules.
Does PSYPACT mean I do not need to be credentialed in the other state?
No. PSYPACT covers the license. Payer credentialing is a separate step, and your malpractice cover has to reach the other state as well.
Keep reading
- Psychology billing →
- Credentialing for therapists and behavioral health →
- CAQH provider profile guide →
- Payer enrollment →
- Psychological and neuropsychological testing billing →
- Counselor credentialing (LCSW, LPC, LMFT) →
- PMHNP credentialing →
- Child and adolescent mental health billing →
- The client portal →
- Pricing →
+ − Sources: 17 checked 2026-10-04
- 42 CFR 410.71, Clinical psychologist services, checked 2026-10-04
- 42 CFR 410.32, Diagnostic tests (supervision of psychological testing), checked 2026-10-04
- CMS, Medicare enrollment applications (PECOS), checked 2026-10-04
- CMS, Medicare Claims Processing Manual, Chapter 26 (physician specialty codes), checked 2026-10-04
- CMS, Medicare & Mental Health Coverage (MLN1986542, March 2026), checked 2026-10-04
- APA Services, Medicare coverage of psychological services, checked 2026-10-03
- CMS, NPPES NPI Registry, checked 2026-10-04
- CMS, NPI fact sheet (December 2024), checked 2026-10-03
- DataSpring (formerly CAQH), For Clinicians, checked 2026-10-04
- DataSpring, Provider Data Profile FAQs for Clinicians, checked 2026-10-04
- PSYPACT, Practicing telepsychology, checked 2026-10-04
- PSYPACT, Practicing temporarily, checked 2026-10-04
- PSYPACT, Application FAQs, checked 2026-10-03
- PSYPACT, State legislation, checked 2026-10-04
- PSYPACT, Iowa passes PSYPACT legislation, checked 2026-10-04
- Aetna, Provider and facility participation criteria (behavioral health), checked 2026-10-04
- Evernorth Behavioral Health, Join the network, checked 2026-10-03
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