New Hampshire Billing Guide for Mental Health Therapists and Psychiatrists
Who pays, where to enroll and which rules change your claims in New Hampshire, for psychotherapists and psychiatric prescribers.
Last checked October 25, 2026. Reviewed against the official sources listed at the bottom of this page.
This New Hampshire billing guide covers Medicaid, Medicare, Blue Cross, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
New Hampshire billing guide: how New Hampshire pays for outpatient care
The New Hampshire Department of Health and Human Services (DHHS) runs NH Medicaid. Most members get care through Medicaid Care Management (MCM), where three managed care organizations (AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan) cover the same services; a smaller group stays in fee-for-service, billed through the NH MMIS portal (Conduent).
Fee-for-service initial claims must be filed within 15 months of the earliest date of service (DHHS memo GM#23-011, effective 7/1/2023), while NH Healthy Families sets 120 days for initial claims. The Blue Cross licensee shown in NH Insurance Department parity orders is Anthem Blue Cross and Blue Shield (New Hampshire); Medicare Part B is handled by National Government Services (Jurisdiction K).
Who to bill, at a glance
| Payer type | Who you bill | Where to enroll or check rules |
|---|---|---|
| Medicaid | NH Medicaid, with Medicaid Care Management (managed care) and fee-for-service; Granite Advantage is the expansion adult program (named in NH Healthy Families and CMS materials): New Hampshire Department of Health and Human Services (DHHS), Division of Medicaid Services | Provider enrollment |
| Medicare Part B | National Government Services, Inc. (NGS) | CMS MAC page |
| Blue Cross Blue Shield | Anthem Blue Cross and Blue Shield (New Hampshire) | See the Blue Cross section below |
New Hampshire Medicaid and how to bill it
This New Hampshire billing guide starts with Medicaid, because it decides who pays and how you file.
DHHS says Medicaid Care Management provides NH Medicaid benefits through contracts with MCOs (Medicaid Health Plans): AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan, which cover the same services but may differ in networks, prior authorization rules and value-added programs.
| Item | What to know |
|---|---|
| Agency | New Hampshire Department of Health and Human Services (DHHS), Division of Medicaid Services |
| Claims or fiscal agent | Conduent runs the NH MMIS fee-for-service claims system (portal NHMMIS.NH.GOV; EDI testing with Conduent EDI; paper CMS-1500 claims to Conduent Claims Unit, P.O. Box 2003, Concord, NH 03301). MCO members: bill the MCO. Source document dated November 8, 2022. |
| Provider enrollment | Official enrollment page |
| Manual or fee schedule | Official manual or fee schedule |
| Provider portal | Provider portal |
| Work requirement | Federal: Medicaid.gov says beginning January 1, 2027 states must condition Medicaid eligibility on community engagement unless a state implements sooner; the interim final rule (CMS-2454-IFC) is listed as posted 06/01/2026, and a medical frailty slide deck was posted 09/08/2026. |
Managed-care plans and carve-outs
| Plan or entity | Role in behavioral health |
|---|---|
| NH Healthy Families (legal name Granite State Health Plan on the DHHS award page) | Provider and member services 1-866-769-3085. |
| WellSense Health Plan (Boston Medical Center Health Plan on the DHHS award page) | NH Medicaid provider service center 877-957-1300 (Quick Reference Guide updated 8/24/26). |
| AmeriHealth Caritas New Hampshire | Named by DHHS as one of the three MCOs (member services 1-833-704-1177 on the DHHS page). |
Medicaid timely filing: DHHS memo GM#23-011 (dated 6/29/2023, effective 7/1/2023) says all providers must submit all initial claims within 15 months following the earliest date of service on the claim and does not distinguish fee-for-service from MCO claims.
Medicare Part B in New Hampshire
For Medicare, this New Hampshire billing guide names your contractor and the current telehealth rules.
As of 2026-10-25, per CMS Telehealth FAQ (updated 10/8/26): Medicare telehealth flexibilities run through December 31, 2027, including audio-only at home.
| Item | What to know |
|---|---|
| Contractor | National Government Services, Inc. (NGS) |
| Jurisdiction | Jurisdiction K (JK) A/B MAC: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont. |
| Source | CMS.gov MAC page |
Blue Cross Blue Shield in New Hampshire
This part of the New Hampshire billing guide names the exact Blue Cross licensee, because Blue plans never share rules.
Blue Cross Blue Shield is a federation of independent companies, so one licensee's rules never apply to another. Here is who holds the Blue license in New Hampshire.
| Licensee | Parent or affiliation | Where it applies | Provider resources |
|---|---|---|---|
| Anthem Blue Cross and Blue Shield (New Hampshire) | Blue Cross Blue Shield Association licensee | New Hampshire (the NH Insurance Department parity release and Anthem's NH provider news both name Anthem Blue Cross and Blue Shield in New Hampshire). | Source |
Other private payers and EAPs in New Hampshire
The New Hampshire billing guide also covers commercial plans and employee assistance programs.
These commercial payers and plan families most often matter for behavioral health billing in New Hampshire. Check each payer's current provider manual before you submit.
| Payer | Behavioral health note | Provider resources |
|---|---|---|
| Harvard Pilgrim Health Care (Point32Health) | Named with Anthem in the NH Insurance Department's March 31, 2023 parity final orders. | Official page |
| Ambetter from NH Healthy Families (Marketplace) | Provider QRG dated January 2026: provider services 1-844-265-1278, payer ID 68069, timely filing 180 days from date of service for participating and 90 days for non-participating providers. | Official page |
| WellSense Clarity and WellSense NH Medicare Advantage | WellSense Quick Reference Guide (8/24/26) lists NH Clarity 855-833-8122 and NH Medicare Advantage 866-808-3833. | Official page |
| Aetna | Provider contact page lists 1-888-632-3862 for non-Medicare plans and 1-800-624-0756 for Medicare plans; mental health and substance use treatment questions use the number on the member ID card. | Official page |
| Cigna / Evernorth Behavioral Health | Cigna provider Contact Us (national): 800-882-4462 telephone transactions, credentialing and appeals; Evernorth Behavioral Health 800-926-2273. Not NH-specific. | Official page |
| UnitedHealthcare / Optum | UHC provider Contact Us lists Provider Services 877-842-3210 and a New Hampshire entry of Network Management in Waltham, MA plus health plan support lines. | Official page |
| Carelon Behavioral Health (Anthem commercial and Medicare Advantage in NH) | National Provider Service Line 1-800-397-1630 (8 a.m. to 8 p.m. ET Mon-Fri) on a quick reference guide dated 2.7.2023; claims through Availity. | Official page |
New Hampshire billing guide: state law that changes billing
Use this section of the New Hampshire billing guide to separate state law from payer policy.
State law sets the floor for commercial plans in New Hampshire. Medicare and Medicaid rules are covered in their own sections above.
Mental health parity
RSA 417-E:1 requires insurers, nonprofit health service corporations and HMOs issuing accident or health coverage in New Hampshire to cover diagnosis and treatment of listed biologically based mental illnesses (including schizophrenia and other psychotic disorders, major depressive disorder, bipolar disorder, OCD, panic disorder, and chronic PTSD) no less extensively than coverage for any other type of health care. Citation: RSA 417-E:1; NH Insurance Department final orders, March 31, 2023. Source
Telehealth coverage and payment parity
RSA 415-J:3 bars an insurer from denying coverage solely because a service is delivered by telemedicine, and requires coverage and reimbursement on the same basis as in-person services; the combined payment to the distant and originating sites must equal the total allowed for in-person care, telemedicine may not be reimbursed more than in person, and telemedicine-only benefit limits are not allowed unless equally imposed on in-person services. Citation: RSA 415-J:3. Source
Prompt payment and timely filing
RSA 420-J:8-a (as read on gc.nh.gov) has health carriers pay or deny a clean electronic claim within 15 calendar days and a clean non-electronic claim within 30 calendar days, adjudicate within 45 calendar days after receiving requested information, mail checks within 5 business days of issue, and pay interest of 1.5 percent per month from the due date on overdue claims. Citation: RSA 420-J:8-a; NH DHHS GM#23-011; NHHF Billing Manual (Feb 2026). Source
Practitioner scope: therapists and prescribers
Anthem's NH notice does confirm that unlicensed master's-level clinicians seeking licensure may bill under a licensed supervisor with the HO modifier for Anthem commercial and Medicare Advantage plans. Source
Not legal advice. Confirm statute details with counsel.
New Hampshire billing guide: codes and rates
This New Hampshire billing guide lists only codes and rates confirmed on official pages.
These are the New Hampshire-specific codes, modifiers and rate items confirmed on official pages.
| Code or item | What to know |
|---|---|
| NH Medicaid fee-for-service physician and other licensed practitioner fee schedule (SPA 25-0020) | CMS approved SPA NH-25-0020 on May 19, 2026 with an effective date of September 1, 2025; it updates procedure codes for physician and other licensed practitioner fee schedules, adds quarterly HCPCS updates at 60% of the Medicare rate, and pays manually priced codes at 25% of submitted charges. Source |
| Community mental health program payments in MCO capitation | Medicaid.gov (posted 12/26/2024) shows a uniform dollar increase for community mental health programs in NH capitation rates, effective September 1, 2024, through a separate payment term up to $4,166,666.67; approval dated November 14, 2024 for a rating period ending June 30, 2025. Source |
| Commercial reimbursement benchmark in RSA 417-E:1 | Mental health and substance use disorder provider payments should, on average, equal or exceed relative Medicare reimbursement for the same service. Source |
| HO modifier for supervised unlicensed clinicians (Anthem NH) | Effective 1/1/2023, billed under the supervising licensed NH participating provider at the master's-level rate for eligible codes; audit on request. Source |
| Behavioral health taxonomy codes (WellSense) | WellSense says behavioral health claims without required taxonomy codes for billing and rendering providers are denied starting Sept. 1, 2026. Source |
New Hampshire billing guide: what changed, newest first
Check this New Hampshire billing guide update log before you rely on an older rule.
| Date | What changed | Source |
|---|---|---|
| 2027-01-01 | Scheduled: federal Medicaid community engagement requirement begins; NH Healthy Families told Granite Advantage members the 80-hour requirement starts this date. | Source |
| 2026-10-08 | CMS Telehealth FAQ updated: Medicare telehealth flexibilities through 12/31/2027; in-person requirement for mental health telehealth after 12/31/2027. | Source |
| 2026-09-08 | Medicaid.gov posted a slide deck on implementing medical frailty under community engagement. | Source |
| 2026-09-01 | WellSense: behavioral health claims without required taxonomy codes are denied starting this date. | Source |
| 2026-08-26 | NH Healthy Families issued a contact sheet listing separate behavioral health payor ID 68068 and claims address. | Source |
| 2026-06-01 | CMS interim final rule on Medicaid community engagement (CMS-2454-IFC) listed as posted. | Source |
| 2026-05-19 | CMS approved NH SPA 25-0020 (physician and other licensed practitioner fee schedules), effective 9/1/2025. | Source |
How do I bill mental health claims in New Hampshire?
These answers come from the same sources as the rest of this New Hampshire billing guide.
The New Hampshire Department of Health and Human Services (DHHS) runs NH Medicaid. Most members get care through Medicaid Care Management (MCM), where three managed care organizations (AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan) cover the same services; a smaller group stays in fee-for-service, billed through the NH MMIS portal (Conduent). Start with the member's payer type: Medicaid plan, Medicare Part B, a Blue Cross licensee or another commercial plan.
Questions about billing in New Hampshire
How long do I have to bill NH Medicaid claims?
DHHS memo GM#23-011 (effective 7/1/2023) says all providers must submit initial claims within 15 months of the earliest date of service on the claim. Managed care plans can be much shorter: NH Healthy Families allows 120 days for initial claims. Check each plan's manual before you bill.
Which plans manage NH Medicaid behavioral health claims?
NH Medicaid members are mostly enrolled in AmeriHealth Caritas New Hampshire, NH Healthy Families or WellSense Health Plan, which cover the same services. NH Healthy Families uses a separate behavioral health payor ID (68068), and WellSense has handled NH Medicaid behavioral health itself since Dec. 1, 2025. Fee-for-service claims go through the NH MMIS.
Which Blue Cross plan covers New Hampshire?
The NH Insurance Department's parity orders and Anthem's NH provider news name Anthem Blue Cross and Blue Shield (New Hampshire). Blue plans are independent licensees, so do not apply another state's Blue rules. Anthem NH pays supervised unlicensed master's-level clinicians under the supervisor's NPI with the HO modifier.
Does New Hampshire require telehealth payment parity for commercial plans?
RSA 415-J:3 requires insurers to cover and reimburse telemedicine on the same basis as in-person care and caps the combined payment at the in-person allowance. Insurers cannot add telemedicine-only limits. Coverage can still be limited to medically necessary services.
Does MCM South bill for practices in New Hampshire?
MCM South currently serves ten states; request a quote to ask about New Hampshire.
Sources for the New Hampshire billing guide
Last checked October 25, 2026. Every source below was opened and read on that date.
- CMS Telehealth FAQ (updated 10/8/26), checked October 25, 2026
- NH DHHS Provider Billing SOP / GM#23-011 (6/29/2023), checked October 25, 2026
- NH DHHS Medicaid Care Management, checked October 25, 2026
- NH DHHS awards Medicaid managed care contracts, checked October 25, 2026
- RSA 417-E:1 (gc.nh.gov), checked October 25, 2026
- NH Insurance Department parity final orders release (3/31/2023), checked October 25, 2026
- RSA 415-J:3 (gc.nh.gov), checked October 25, 2026
- RSA 420-J:8-a (gc.nh.gov), checked October 25, 2026
- NH Insurance Department: Filing a Complaint, checked October 25, 2026
- NH MMIS claims submission overview (11/8/2022), checked October 25, 2026
- NH Medicaid provider enrollment overview (rev. 9/20/2022), checked October 25, 2026
- NH MMIS provider resources page, checked October 25, 2026
- Medicaid.gov NH behavioral health outpatient fee schedule renewal (posted 12/26/2024), checked October 25, 2026
Related guides
- State & Regional Billing Guides hub
- In-network vs out-of-network credentialing
- Credentialing and network status
- Mental health parity explained
- Medicaid managed care billing
- Medicare behavioral health billing
- Timely filing in the billing glossary
- Who we serve
- Massachusetts insurance companies contact guide
- Connecticut insurance companies contact guide
- New York insurance companies contact guide
- Pennsylvania insurance companies contact guide
Billing in New Hampshire? Let us handle the payer calls.
MCM South bills only mental and behavioral health, for psychotherapists and psychiatrists, in solo and medium-size practices. We currently serve ten states; request a quote to ask about New Hampshire.
MCM South currently serves practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.