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.

Last reviewed 2026-10-04.

Where a practice with no office gets stuck

For a virtual-only practice, most problems start at enrollment and licensing, before a single claim goes out.

  1. Medicare wants an address, and home is all you have

    A clinician whose only practice location is home must list the home address on the Medicare enrollment. That address does not have to be public. Medicare has a location type that keeps it off its public search.

  2. Clients who move or log in from another state

    Licensure follows the client. You must be licensed, or otherwise allowed to practice, in the state where the client is during the session. A client who moves or travels can take you outside your license.

  3. 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 you must meet before you apply.

  4. Home sessions billed as if the client were somewhere else

    Medicare pays telehealth to a client at home at the non-facility rate, which is the higher office rate. The claim should show where the client actually was.

What we handle, and what stays with you

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.

Enrolling in Medicare when home is your only office

CMS revised its telehealth enrollment guide on July 23, 2026. It says the pandemic-era flexibility for clinicians who work from home, without a public home address, "is now permanent policy." Some articles still say otherwise; the CMS guide is the current word.

Home-only practice: list the home address. If you provide virtual-only telehealth and your home is your only practice location, you must report it as a practice location. There is no way around listing it.

Keep it off Care Compare. Choose the location type "Home Office for Administrative/Telehealth Use Only." CMS says this keeps your home address from being published on Care Compare, Medicare's public provider search.

Suppression while the application is processed. If you ask, CMS will suppress your home address while the enrollment application is being processed. CMS names its Quality Payment Program email for these requests.

If you also have an office, leave home off. A clinician with a physical office who sometimes sees patients from home does not report the home address. You enroll and bill from the office as if the session were in person.

A virtual-only group uses the clinician's home. A group with no office lists the clinician's home address as the group's practice location, since there is no physical one.

Enroll where you are, not where the client is. You do not enroll in the states where your Medicare patients live. CMS does require a separate enrollment for each state you practice from. Medicare contractors check your license only in the state where you are, so meeting the client's state rules is up to you.

Licensure and credentialing across state lines

Medicare enrollment follows where you are. Licensure, and payers such as Aetna, follow where the client is.

  1. Licensed where your clients are

    You need a license, or a compact privilege where one applies, in each state where you see clients. Aetna, for example, requires licensure in every state where the members you treat are located.

  2. Psychologists: PSYPACT

    PSYPACT lets authorized psychologists offer telepsychology to clients in other member states while physically in their home state. More than 40 states have joined, plus DC. Check the PSYPACT map for states currently in effect.

  3. Counselors: the Counseling Compact

    As of October 1, 2026, ten states are issuing privileges to practice: Arizona, Arkansas, Georgia, Indiana, Louisiana, Minnesota, Ohio, Oklahoma, Tennessee and Wyoming.

  4. Social workers: not yet

    The Social Work Licensure Compact has been enacted in many states, but multistate licenses are not yet available. Until they are, a social worker needs a license in each client's state.

  5. Payer applications, state by state

    Once you can practice in a state, we file each payer application there, follow up until approval, and record each effective date in your client portal.

Credentialing is $150 per application, per provider. In our experience it usually takes 60 to 90 days with each payer. A license or compact privilege comes first; payers still need to credential you.

What Medicare and Aetna require of a virtual-only practice

Medicare: the client's home counts, permanently

Under permanent law, the patient's home is an allowed telehealth location for mental health care, with no rural requirement. After 2027, most other services lose that rule; behavioral health keeps it. Clinical psychologists, clinical social workers, marriage and family therapists and mental health counselors can all bill Medicare telehealth.

Medicare: place of service, in words

Medicare has one place of service for telehealth in the patient's home and another for telehealth anywhere else. Home sessions are paid at the non-facility rate. For the rest of telehealth claim setup, see our telehealth billing page.

Medicare: audio-only sessions

For behavioral health, Medicare allows two-way, audio-only sessions when the patient is at home.

Medicare: the in-person visit rule starts in 2028

The in-person requirement is delayed to January 1, 2028. Clients who start mental health telehealth on or before December 31, 2027 count as established. They will need one in-person visit every 12 months after that date.

Aetna: the Virtual Only Provider category

Aetna's Virtual Only Providers do not need a physical office or to see members in person. They must have referral arrangements with a participating provider no more than 30 minutes from the member, or longer for rural members as Aetna decides.

Aetna: platform and code rules

Aetna requires HIPAA-compliant cameras and software, the patient's informed consent, and software that meets accessibility guidelines (WCAG 2.1). It pays only the telehealth codes on its own telemedicine payment policy. Other plans set their own rules, so we check each payer before you apply.

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 you see clients through a platform that bills for you, such as Headway or Alma, 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 revenue audit before you sign is free.

Sources

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