Behavioral Health
Behavioral health credentialing: Medicare, CAQH and the dates that lapse
Since 1 January 2024, marriage and family therapists and mental health counselors can bill Medicare themselves, enrolling through PECOS or the CMS-855I, separately in each state where they see patients. Health plans use CAQH data (CAQH is now DataSpring) for credentialing; the portal is free for providers but must be re-attested every 120 days. A credentialing seat is $2,200 a month.
Medicare: therapists and counselors since 2024
Section 4121 of Division FF of the Consolidated Appropriations Act, 2023 created a Medicare benefit for services furnished and billed by marriage and family therapists and mental health counselors. Payment began on 1 January 2024, at 75% of what a clinical psychologist is paid under the Physician Fee Schedule, per CMS.
They enroll electronically through PECOS or on the paper CMS-855I. On paper there is no MFT or MHC line: CMS’s May 2024 FAQ says to select the Undefined Non-Physician Practitioner Specialty option in section 2H and write MFT or MHC. A separate CMS-855I is required in each state where services are rendered, and CMS screens both types as limited risk.
Eligibility has its own detail. A marriage and family therapist needs at least 2 years or 3,000 hours of post-master’s clinical supervised experience in an appropriate setting.
Source: CMS, MFT and MHC provider enrollment FAQs (May 2024, PDF) · CMS, marriage and family therapists and mental health counselors
CAQH, now DataSpring: free, and due every 120 days
The CAQH Provider Data Portal (ProView) is where practitioners enter, update and verify their professional and practice information and share it with the organizations they authorize. Providers use it free of charge; health plans and other organizations pay to use the data for credentialing. CAQH rebranded as DataSpring on 7 June 2026.
The cost is the calendar. A profile must be attested every 120 days (every 180 in Illinois), or its status changes to Expired.
Telehealth from home, and the in-person rule
Medicare patients can permanently receive behavioral and mental health telehealth services in their homes, and marriage and family therapists and mental health counselors can permanently serve as distant-site providers, per HHS.
The in-person visit within six months of an initial behavioral telehealth service, and annually after it, is not required through 31 December 2027. Put that date in the calendar.
Revalidation: every five years for Medicare
To keep Medicare billing privileges, a provider other than a DMEPOS supplier must resubmit and recertify its enrollment information every 5 years, and CMS may ask for an off-cycle revalidation. Our free lookup reads CMS’s revalidation list for a provider’s due date.
Medicare enrollment does not enroll anyone with a commercial plan or a Medicaid managed care plan. Each of those credentials clinicians under its own policy and its own panel decisions.
Source: 42 CFR 424.515, Medicare revalidation (eCFR) · CMS, Medicare revalidations
What a credentialing seat does for a behavioral health group
One full-time person, $2,200 a month, working your payers’ portals and your systems through access you control.
- A roster of every clinician against every payer and state, with each application’s real status
- A CAQH attestation calendar for every clinician, worked before the 120 days run out
- Medicare enrollment packets for new therapists and counselors, one per state where they see patients
- Payer follow-up until an effective date is issued
- Licence, malpractice and Medicare revalidation dates tracked ahead of time
- Signing an attestation for a clinician: that goes to the clinician or your authorized official
- A promised panel seat or effective date: the payer decides, and some panels are closed
Questions
Can a licensed mental health counselor bill Medicare?
Yes, since 1 January 2024. Marriage and family therapists and mental health counselors can enroll and bill Medicare for the diagnosis and treatment of mental illness, paid at 75% of the clinical psychologist rate under the Physician Fee Schedule, per CMS.
Which form does a marriage and family therapist use to enroll in Medicare?
PECOS online, or the paper CMS-855I. On paper, CMS’s May 2024 FAQ says to choose the Undefined Non-Physician Practitioner Specialty in section 2H and write MFT or MHC. A separate enrollment is needed in each state where services are rendered.
How often must a CAQH profile be attested?
Every 120 days, or every 180 days in Illinois. If it is not, the profile’s status changes to Expired.
Is Medicare telehealth for mental health from home permanent?
Per HHS, yes: Medicare patients can permanently receive behavioral and mental health telehealth at home. The in-person visit requirement is not required through 31 December 2027.
What does a behavioral health credentialing seat cost?
$2,200 a month for one full-time person, one month minimum, no setup fee, working from Rawalpindi, Pakistan, on US business hours.
A research summary, not legal, coding or coverage advice. Payer policy and the applicable LCD govern any individual claim; every rule above links to the document it came from so you can check it rather than trust it.
Sources
- CMS, MFT and MHC provider enrollment FAQs (May 2024, PDF)
- CMS, marriage and family therapists and mental health counselors
- CAQH (now DataSpring), Provider Data Portal FAQ
- HHS, telehealth policy updates (telehealth.hhs.gov)
- 42 CFR 424.515, Medicare revalidation (eCFR)
- CMS, Medicare revalidations
Sources checked 9 October 2026.
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Next step
A credentialing seat for your behavioral health group, $2,200 a month
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