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.

Last reviewed 2026-10-04.

What holds up a psychologist's application

Most delays come from a few avoidable mistakes. Each one below is tied to a published rule.

  1. Enrolled in Medicare as the wrong kind of psychologist

    Medicare has two psychologist types. One of them can bill only diagnostic tests that a physician or practitioner ordered. A doctoral psychologist with an independent license who lands in that type cannot bill therapy at all.

  2. A lapsed CAQH attestation

    Commercial payers read your CAQH profile, and it has to be re-attested every 120 days (every 180 days in Illinois). Evernorth lists the same 120-day re-attestation in its own network rules. A profile that has lapsed can leave an application sitting.

  3. A group that wants only some plans

    Aetna says that in a group practice, every participating provider must meet its criteria and join all plans in the group agreement. A group cannot pick one product and skip the rest.

  4. Clients in another state

    PSYPACT can cover the license side, but each kind of authorization needs its own certificate from ASPPB. Malpractice cover has to reach that state too: Aetna requires coverage that extends to every state where care is given.

Who does what on a psychologist'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.

Two ways to enroll in Medicare as a psychologist

This choice is made on the enrollment application, and it decides what you can bill. Medicare names the two types "Clinical Psychologist" and "Psychologist (Billing Independently)".

Clinical psychologist. You hold a doctoral degree in psychology and a license at the independent practice level in the state where you practice, based on that doctorate. You can bill treatment and testing. Medicare pays the full fee schedule rate only if you accept assignment.

Independently practicing psychologist. This is a psychologist who is not a clinical psychologist and practices on their own responsibility, free of an employer's control. You can bill diagnostic psychological and neuropsychological tests only, when a physician or certain practitioners order them. The claim must name the ordering practitioner.

What the type means for testing staff. Medicare allows testing furnished by staff under the general supervision of a physician or clinical psychologist. General supervision means your overall direction and control; you do not have to be in the room. An independently practicing psychologist must give the tests personally.

Your signature carries a promise. Signing the Medicare enrollment form is how a clinical psychologist agrees to the rule on consulting the patient's primary care doctor. Neither you nor the doctor 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, so that no payer sees two different versions of you.

  1. NPI records that match the license

    An NPI is free. If you are incorporated, you can hold an individual NPI and a separate one for your corporation or LLC. NPPES has two psychologist descriptions, "Psychologist" and "Psychologist, Clinical", and we check that yours matches your license and your Medicare type.

  2. CAQH profile built and kept current

    The CAQH profile is free for clinicians. We load your license, malpractice and work history, and re-attest every 120 days (180 in Illinois).

  3. Medicare enrollment, individual and group

    Psychologists enroll as non-physician practitioners, online in PECOS or on paper; CMS says PECOS applications tend to process faster. A practice billing as a group also files Medicare's application for clinics and group practices. The electronic funds transfer agreement and the participating supplier agreement routinely go in with it.

  4. Commercial and behavioral health networks

    We file with each payer you choose, check its published criteria first, and follow up until there is a decision. Medicare does not pay for services by interns or postdocs, even under supervision, so only licensed psychologists go on your Medicare file.

  5. PSYPACT, if you see clients in other states

    PSYPACT gives two separate authorizations: the APIT covers telepsychology and needs an ASPPB E.Passport, and the TAP covers in-person work for up to 30 calendar days a year in each PSYPACT state where you are not licensed, and needs an ASPPB Interjurisdictional Practice Certificate. Neither one adds you to a payer's network, so we still file with each payer.

  6. Effective dates in your portal

    Each application shows its stage in your client portal, along with any document we need from you. When a payer approves you, we record the effective date there, so you know when you can start seeing its members.

More than 40 states have passed PSYPACT laws. Alaska and Iowa passed theirs in 2026, and Iowa's takes effect July 1, 2027. Check the PSYPACT map for the states in effect today.

What payers look for in a psychologist

Medicare

A doctorate in psychology and a license at the independent practice level in your state, for the clinical psychologist type. Without both, Medicare's only psychologist route is the testing-only type.

Evernorth (Cigna)

A license to practice independently, without supervision, in the state where you provide services, and re-attestation every 120 days. Evernorth says joining its network 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 must meet the criteria and join all plans in the group agreement.

Every commercial payer

A complete, attested CAQH profile. We keep yours attested so it is current whenever a payer reads it.

When you may not need us yet

If you are still a postdoc or not yet licensed at the independent level, there is little to file yet. Come back when the license is issued, and we can start the applications then.

If your practice is entirely self-pay and you do not plan to join any panels, you do not need credentialing.

If you only want billing, not credentialing, see psychology billing instead. We bill inside SimplePractice, TherapyNotes and the other systems psychologists use, 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?

If you have 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, which means 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.

Sources

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

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