Therapy practices that see every client online
Telehealth Therapy Billing and Credentialing for Virtual-Only Practices
Medtransic handles telehealth therapy billing and credentialing for therapists and groups who see every client online, with no office. We enroll you in Medicare using your home address, marked so it is not published, credential you with payers in the states where your clients are, and bill inside SimplePractice, TherapyNotes or your current system. Billing is 4-8% of what we collect for you. Credentialing is $150 per application, per provider. In our experience it usually takes 60 to 90 days with each payer.
What a virtual-only practice needs
Illustrative- 01
Home address on Medicare enrollment
If home is your only office
- 02
Telehealth-only location type
Keeps home off Care Compare
- 03
License in the client's state
Or a compact privilege
- 04
Payer credentialing
Where your clients are
- 05
Insurance verification
Before the first session
- 06
Client location noted
At each session
- 07
Place of service on the claim
Home or somewhere else
- 08
Informed consent
Aetna
- 09
HIPAA-compliant platform
Aetna
- Billing
- 4-8%
- of what we collect for you
- Credentialing
- $150
- per application, per provider
- Tracking
- Live
- every claim and application in your portal
- Contract
- None
- no long-term contract
Where a practice with no office gets stuck
For a virtual-only practice, most problems start at enrollment and licensing, before a claim goes out.
Home is your only Medicare address
A clinician whose only practice location is home must list it on the Medicare enrollment. A Medicare location type keeps it off public search.
Clients who move or log in elsewhere
You must be licensed, or otherwise allowed to practice, where the client is during the session. A client who moves or travels can take you outside your license.
A commercial application that assumes an office
Aetna's network criteria include rules for physical offices. It also has a separate path for virtual-only providers, with conditions to meet before you apply.
Home sessions billed as somewhere else
Medicare pays telehealth to a client at home at the non-facility rate, the higher office rate. The claim should show where the client actually was.
What we handle, and what stays with you
Medtransic runs
- Medicare enrollment in PECOS, with your home marked as a telehealth-only office
- Payer credentialing in each state where your clients are
- Insurance verification before the first session
- Claims that show whether the client was at home or somewhere else
- Payment posting, denials, appeals and A/R follow-up
- Applications, documents we need and claims, all visible in your client portal
Your practice keeps
- Your state licenses and any compact privileges
- Confirming where the client is at each session, and noting it
- Clinical work, client consent and your video platform
- Your EHR and your client relationships
Enrolling in Medicare when home is your only office
CMS's telehealth enrollment guide, revised July 23, 2026, says this work-from-home flexibility "is now permanent policy."
- 01
Home is your only office
- What CMS says
- Report the home address as a practice location. There is no way around listing it.
- 02
You want home kept private
- What CMS says
- Choose "Home Office for Administrative/Telehealth Use Only" and CMS keeps it off Care Compare.
- 03
Application still processing
- What CMS says
- If you ask, CMS suppresses your home address while it processes the application.
- 04
You also have an office
- What CMS says
- Leave home off. Enroll and bill from the office as if the session were in person.
- 05
A group with no office
- What CMS says
- List the clinician's home address as the group's practice location.
- 06
Clients in other states
- What CMS says
- Enroll in each state you practice from, not where clients live. Contractors check your license only where you are.
Licensure and credentialing across state lines
Medicare follows where you are; licensure and payers such as Aetna follow where the client is.
Licensed where your clients are
You need a license, or a compact privilege where one applies, in each state where you see clients, as Aetna requires.
Psychologists: PSYPACT
Authorized psychologists can offer telepsychology to clients in other member states from their home state, and more than 40 states plus DC have joined.
Counselors: the Counseling Compact
As of October 1, 2026, ten states issue privileges: Arizona, Arkansas, Georgia, Indiana, Louisiana, Minnesota, Ohio, Oklahoma, Tennessee and Wyoming.
Social workers: not yet
Multistate social work licenses are not yet available, so a social worker needs a license in each client's state.
Payer applications, state by state
Once you can practice in a state, we file each payer application there and record each effective date in your client portal.
A license or compact privilege comes first; payers still need to credential you.
What Medicare and Aetna require of a virtual-only practice
Medicare and Aetna both set rules for practices with no office; other plans set their own, so we check each one.
| Payer | Rule | What it means for you |
|---|---|---|
| Medicare: the client's home | Under permanent law, home is an allowed telehealth location for mental health care, with no rural requirement. Behavioral health keeps this after 2027. | Clinical psychologists, clinical social workers, marriage and family therapists and mental health counselors can all bill Medicare telehealth. |
| Medicare: claims | One place of service for telehealth at home, another for anywhere else. Home sessions are paid at the non-facility rate. | Audio-only sessions are allowed for behavioral health when the client is at home. |
| Medicare: in-person visit | The requirement is delayed to January 1, 2028. | Clients who start on or before December 31, 2027 count as established, then need one in-person visit every 12 months. |
| Aetna: Virtual Only Provider | No physical office or in-person visits needed. | You need referral arrangements with a participating provider within 30 minutes of the member, or longer for rural members as Aetna decides. |
| Aetna: platform and codes | HIPAA-compliant cameras and software, the patient's informed consent, and WCAG 2.1 accessibility. | Aetna pays only the telehealth codes on its own telemedicine payment policy. |
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 another setup may suit you better
- If every client pays you directly and you do not plan to join insurance panels, you do not need a billing company.
- If a platform such as Headway or Alma bills for you and the rates work, staying can be simpler. We help when you want your own contracts.
- Credentialing does not replace a license. If you are not licensed in the state where a client is, no payer application changes that.
Questions from therapists who practice only online
Do I need a physical office to bill insurance for teletherapy?
Not for Medicare: a virtual-only clinician enrolls with the home address as the practice location. Aetna also has a Virtual Only Provider category, with conditions. Other payers set their own rules, so we check each one.
Will my home address be public if I enroll in Medicare?
It does not have to be. Mark it as a "Home Office for Administrative/Telehealth Use Only" location, and CMS keeps it off Care Compare. CMS made this permanent policy in its July 2026 guide.
Do I need to enroll in Medicare in every state where my clients live?
No. CMS says you are not required to enroll in the state where the patient lives. You still need to be licensed, or otherwise allowed to practice, in the client's state.
Can I see a client who is traveling in another state?
Only if you can legally practice in the state where the client is during the session. That means a license there, or a compact privilege such as PSYPACT or the Counseling Compact where it applies.
Does Medicare require an in-person visit for teletherapy?
Not before January 1, 2028. Clients who start before then count as established and will need one in-person visit every 12 months after that date.
Can social workers use the compact yet?
Not yet. The Social Work Licensure Compact has passed in many states, but multistate licenses are not available yet.
What does Medtransic charge a telehealth-only practice?
Billing is 4-8% of what we collect for you. Credentialing is $150 per application, per provider. There is no long-term contract, and the consultation before you sign is free.
Keep reading
- Telehealth billing →
- Credentialing for therapists and behavioral health →
- Mental and behavioral health billing services →
- Psychology billing →
- Leaving Headway, Alma or Grow →
- Counselor credentialing (LCSW, LPC, LMFT) →
- PMHNP practice billing →
- Pricing →
+ − Sources: 9 checked 2026-10-04
- CMS, Understanding Telehealth and Teleradiology Enrollment (revised July 23, 2026), checked 2026-10-04
- CMS, Telehealth and Remote Patient Monitoring (MLN901705, December 2025), checked 2026-10-04
- CMS, Telehealth FAQ (updated February 26, 2026), checked 2026-10-04
- HHS, Telehealth licensure: getting started, checked 2026-10-04
- Aetna, Network participation criteria (telehealth and Virtual Only Providers), checked 2026-10-04
- PSYPACT, state legislation, checked 2026-10-04
- PSYPACT, telepsychology, checked 2026-10-04
- Counseling Compact, 10 states now offering privileges, checked 2026-10-04
- Social Work Licensure Compact, checked 2026-10-04
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