Colorado Medicare Part B: 6 Easy Steps for Therapists
Colorado Medicare Part B is the federal outpatient insurance you bill when a Medicare patient sees you for therapy or medication management. Status is current as of October 17, 2026. This is operational guidance, not legal advice. Medicare rules are federal, so most of what follows matches other states. Colorado Medicare Part B differs mainly in who your contractor is. The contractor and the state-specific details are what change.
Who processes Colorado Medicare Part B claims
Medicare uses private companies called Medicare Administrative Contractors (MACs) to process claims. In Colorado, that is Novitas Solutions, Inc., in Jurisdiction H. The CMS Jurisdiction H fact sheet lists Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma and Texas together. If you also bill in Texas, you deal with the same contractor.
Step 1: Check that you can enroll
Medicare Part B only pays clinicians it recognizes. Marriage and family therapists (MFTs) and mental health counselors (MHCs) have billed Medicare directly since January 1, 2024. The CMS page for MFTs and MHCs lists the rules:
- A master’s or doctoral degree that qualifies you for state licensure.
- At least 2 years or 3,000 hours of post-master’s supervised clinical experience.
- A state license or certification as an MFT or MHC.
Medicare pays MFTs and MHCs 75% of the clinical psychologist rate under the Medicare Physician Fee Schedule. Psychiatrists bill as physicians, using evaluation and management (E/M) codes plus add-on psychotherapy codes where they apply.
Step 2: Get your enrollment pieces in order
CMS lists four steps: register in the Identity & Access Management (I&A) system, get a National Provider Identifier (NPI) through NPPES, enroll through PECOS (Provider Enrollment, Chain and Ownership System) or a paper CMS-855 application, and work with your MAC. Do this before you see Medicare patients. Billing before your enrollment is approved is a common and costly mistake.
Step 3: Know the Colorado Medicare Part B filing deadline
Medicare denies a claim if it arrives more than 12 months, or one calendar year, after the date of service. The rule sits in Chapter 1 of the Medicare Claims Processing Manual. A few narrow exceptions exist, such as an administrative error by Medicare or retroactive Medicare entitlement. Do not plan around them. File within weeks, not months. This deadline is the same for every colorado medicare part b claim.
Step 4: Learn the telehealth rules
Medicare telehealth flexibilities now run through December 31, 2027, under the Consolidated Appropriations Act of 2026, per a law firm summary of the law. Behavioral health telehealth from the patient’s home continues. An in-person visit requirement for most patients starts January 1, 2028. Check this each quarter, because Congress has changed these dates many times.
Step 5: Keep Medicare, private payers and state rules separate
Medicare
Federal rules apply. Your MAC processes the claim, and the 12-month limit applies.
Private insurance
Commercial plans set their own filing limits and networks. See our guide to in-network vs out-of-network before you join one. Our Insurance Companies Contact page lists payer contacts.
Colorado state law
State insurance law covers private plans, not Medicare. Colorado’s Medicaid program is also separate. Our State & Regional Billing Guides hub covers the state side.
Step 6: Bill clean and track every claim
A clean claim has correct patient data, the right place of service and an accurate diagnosis. Learn the terms in our Billing Terms Glossary. Then watch your remittances so denials do not age out of the 12-month window.
Practical tips for Colorado Medicare Part B
Start with a short checklist for colorado medicare part b: confirm your NPI, confirm your enrollment effective date, and confirm your telehealth modifiers. Keep a log of every Medicare claim and its filing date. Review it monthly, because colorado medicare part b denials are cheapest to fix in the first 60 days. Add a reminder in your calendar at month ten for any unpaid claim. Our Practice Management & Business Tips hub can help with the business side.
Where MCM South helps
MCM South Medical Billing Service, LLC bills for psychotherapists and psychiatrists only. We serve Georgia (GA), Massachusetts (MA), Connecticut (CT), Texas (TX), Florida (FL), New York (NY), Colorado (CO), Tennessee (TN), North Carolina (NC) and Illinois (IL). If you want a second set of eyes on your claims, Get a Free Quote or Schedule a Consultation.
Keep learning: browse our Resources section, see the State & Regional Billing Guides, and read the Practice Management & Business Tips guides.
More from MCM South: Colorado insurance companies contact guide; Medicare Part B glossary entry; MAC jurisdictions glossary entry; timely filing glossary entry; Medicare behavioral health billing guide; Texas Medicare Part B guide.
FAQs
Who processes Colorado Medicare Part B claims?
Novitas Solutions, Inc. is the Medicare Administrative Contractor for Jurisdiction H, which includes Colorado, per the CMS June 2026 fact sheet.
Can a licensed professional counselor bill Colorado Medicare Part B?
Yes, if enrolled. Mental health counselors and marriage and family therapists have been able to bill Medicare since January 1, 2024, when they meet the CMS education, experience and licensure rules.
How long do I have to file a Medicare claim?
Medicare denies claims received more than 12 months, or one calendar year, after the date of service. Narrow exceptions exist but should not be relied on.
Is telehealth still covered by Medicare for therapy?
Current law extends the flexibilities through December 31, 2027. The in-person visit requirement for most behavioral health patients begins January 1, 2028. Reconfirm before each year-end.
