Louisiana Billing Guide for Mental Health Therapists and Psychiatrists
Who pays, where to enroll and which rules change your claims in Louisiana, for psychotherapists and psychiatric prescribers.
Last checked October 25, 2026. Reviewed against the official sources listed at the bottom of this page.
This Louisiana billing guide covers Medicaid, Medicare, Blue Cross, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
Louisiana billing guide: how Louisiana pays for outpatient care
The Louisiana Department of Health (LDH) runs Louisiana Medicaid, branded Healthy Louisiana, and most members are enrolled in managed care organizations (MCOs) that also cover specialized behavioral health; Gainwell Technologies is the fee-for-service claims processor and enrollment vendor. LDH lists five MCOs (Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Humana Healthy Horizons in Louisiana, Louisiana Healthcare Connections); UnitedHealthcare Community Plan left on March 31, 2026, and Healthy Blue's contract ends December 31, 2026, so four MCOs are expected from January 1, 2027.
LDH bulletins for UnitedHealthcare and Healthy Blue state a 365-day timely filing period for new claims, and La. R.S. 46:442 bars LDH from setting a Medicaid filing limit shorter than 365 days. For commercial plans, Blue Cross and Blue Shield of Louisiana (Louisiana Blue) is the independent Blue licensee and lists 15 months from the date of service as its general timely filing period, and Medicare Part B is handled by Novitas Solutions in Jurisdiction H. Louisiana Medicaid work or community engagement requirements start January 1, 2027 for renewals and new applicants aged 19 to 64, with exemptions that include people in substance use treatment and the medically frail (which LDH says includes disabling mental disorders).
Who to bill, at a glance
| Payer type | Who you bill | Where to enroll or check rules |
|---|---|---|
| Medicaid | Healthy Louisiana (Louisiana Medicaid), with MCO managed care and a Gainwell-processed fee-for-service program: Louisiana Department of Health (LDH), Medicaid | Provider enrollment |
| Medicare Part B | Novitas Solutions, Inc. | CMS MAC page |
| Blue Cross Blue Shield | Blue Cross and Blue Shield of Louisiana (brand: Louisiana Blue) | See the Blue Cross section below |
Louisiana Medicaid and how to bill it
This Louisiana billing guide starts with Medicaid, because it decides who pays and how you file.
Managed care through MCOs.
Behavioral health: No carve-out for specialized behavioral health: since December 1, 2015 it has been delivered through the full-risk MCOs (LDH IB16-3, revised 9/1/2017, and IB15-13, revised 5/12/2026). Licensed mental health professionals (LMHPs) bill the member's MCO.
| Item | What to know |
|---|---|
| Agency | Louisiana Department of Health (LDH), Medicaid |
| Claims or fiscal agent | Gainwell Technologies (fee-for-service claims, provider enrollment portal and eMEVS eligibility). FFS claims line 1-800-473-2783 and P.O. Box 91024, Baton Rouge, LA 70821 per LDH Informational Bulletin 19-3 (revised 7/10/2026). MCO claims go to the member's MCO. |
| Provider enrollment | Official enrollment page |
| Manual or fee schedule | Official manual or fee schedule |
| Provider portal | Provider portal |
| Work requirement | LDH's work requirements page says requirements begin January 1, 2027 for renewals and new applicants aged 19 to 64: 80 hours a month of approved work or community engagement, or earnings of at least $580 a month, or half-time or part-time school enrollment. |
Managed-care plans and carve-outs
| Plan or entity | Role in behavioral health |
|---|---|
| Aetna Better Health of Louisiana | Provider line 1-855-242-0802 per LDH IB19-3 (rev. 7/10/2026). |
| AmeriHealth Caritas Louisiana | Provider line 1-888-922-0007 per LDH IB19-3; the plan's own 3/2026 provider alert shows 1-888-922-0007, daily 7 a.m. to 7 p.m. |
| Healthy Blue (Louisiana Medicaid MCO) | Exits Louisiana Medicaid when its contract ends 12/31/2026 (LDH Bulletin 26-12, 9/1/2026). |
| Humana Healthy Horizons in Louisiana | Provider line 1-800-448-3810 per LDH IB19-3. |
| Louisiana Healthcare Connections | Provider line 1-866-595-8133 per LDH IB19-3. |
| UnitedHealthcare Community Plan (no longer an active MCO) | Ended Louisiana Medicaid participation 3/31/2026; members moved 4/1/2026. |
Timely filing: LDH Bulletin 26-3 (UnitedHealthcare) and Bulletin 26-12 (Healthy Blue) both say new claims are accepted under the 365-day timely filing period, and La. R.S. 46:442(A) says LDH may not limit the filing period for a covered Medicaid service to less than 365 days from the date of service. Check each MCO provider manual for its own rule.
Medicare Part B in Louisiana
For Medicare, this Louisiana 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 | Novitas Solutions, Inc. |
| Jurisdiction | Jurisdiction H (JH): Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma and Texas. |
| Source | CMS.gov MAC page |
Blue Cross Blue Shield in Louisiana
This part of the Louisiana 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 Louisiana.
| Licensee | Parent or affiliation | Where it applies | Provider resources |
|---|---|---|---|
| Blue Cross and Blue Shield of Louisiana (brand: Louisiana Blue) | Independent licensee of the Blue Cross Blue Shield Association. | Louisiana. | Source |
Other private payers and EAPs in Louisiana
The Louisiana billing guide also covers commercial plans and employee assistance programs.
These commercial payers and plan families most often matter for behavioral health billing in Louisiana. Check each payer's current provider manual before you submit.
| Payer | Behavioral health note | Provider resources |
|---|---|---|
| Aetna (commercial) | National provider contact page lists 1-888-632-3862 for indemnity and PPO-based plans. | Official page |
| Cigna / Evernorth Behavioral Health | National provider Contact Us page lists Evernorth Behavioral Health at 800-926-2273 and credentialing at 800-882-4462. | Official page |
| UnitedHealthcare / Optum Behavioral Health (commercial) | UHC provider contact page lists a 24/7 behavioral health and substance use support line (877-614-0484) and general provider assistance (877-842-3210); Optum Provider Express lists Provider Services at 877-614-0484 for credentialing and contracting. | Official page |
Louisiana billing guide: state law that changes billing
Use this section of the Louisiana billing guide to separate state law from payer policy.
State law sets the floor for commercial plans in Louisiana. Medicare and Medicaid rules are covered in their own sections above.
Mental health parity
La. R.S. 22:1043 (Severe mental illness and other mental disorders) applies to group, blanket and association health policies, HMO/PPO contracts, and self-insured and Office of Group Benefits plans delivered or issued in Louisiana; it excludes individual, limited benefit and short-term policies. Citation: La. R.S. 22:1043 (most recent amendment Acts 2021, No. 238). Source
Telehealth coverage and payment parity
Commercial: the title of La. R.S. 22:1821 includes 'telehealth reimbursement by insurers'; the text opened states the telehealth provisions do not apply to limited benefit health policies. Citation: La. R.S. 22:1821 (title); LDH Informational Bulletin 25-28 (rev. 10/20/2025) for Medicaid. Source
Prompt payment and timely filing
Commercial prompt pay (current law as quoted in enrolled SB 465, 2026): contracted providers filing a nonelectronic claim within 45 days of service get a pay, deny or pend decision within 45 days of a clean claim, 60 days for late-filed or resubmitted claims (R.S. 22:1832); electronic claims are decided within 25 days (R.S. 22:1833). Citation: La. R.S. 22:1832, 22:1833, 22:1838; Act 770 (SB 465, 2026); La. R.S. 46:442. Source
Practitioner scope: therapists and prescribers
LDH's Behavioral Health Services Provider Manual (Chapter Two of the Medicaid Services Manual; outpatient therapy section issued 11/27/18) lists independently licensed LMHPs who may bill: medical psychologists, licensed psychologists, LCSWs, LPCs, LMFTs, licensed addiction counselors and APRNs, plus psychiatrists and other prescribers (physicians and physician assistants under a psychiatrist's protocol). Source
Not legal advice. Confirm statute details with counsel.
Louisiana billing guide: codes and rates
This Louisiana billing guide lists only codes and rates confirmed on official pages.
These are the Louisiana-specific codes, modifiers and rate items confirmed on official pages.
| Code or item | What to know |
|---|---|
| Medicaid telehealth billing | LDH Bulletin 25-28. Source |
| Who can bill behavioral health | BHS Provider Manual lists LMHP provider types such as psychologist, social worker, LPC, LMFT, licensed addiction counselor, APRN, psychiatrist, clinical nurse specialist and physician assistant. Source |
| Specialized Behavioral Health Fee Schedule | LDH and plan bulletins point to the Specialized Behavioral Health Fee Schedule on lamedicaid.com for BH rates and telemedicine modifiers. Source |
| Commercial outpatient benefit minimum (R.S. 22:1043) | 52 outpatient visits per covered person per year (including intensive outpatient) and 45 inpatient days for plans subject to the statute. Source |
| New 2026 HCPCS codes | LDH lists Informational Bulletin 26-8, 'Implementation of the New 2026 HCPCS Codes' (revised 7/10/2026). Source |
Louisiana billing guide: what changed, newest first
Check this Louisiana billing guide update log before you rely on an older rule.
| Date | What changed | Source |
|---|---|---|
| 2026-10-14 | LDH's bulletin index lists Informational Bulletin 26-17, 'Updates to Minor Consent Rules for Behavioral Health Services', and 26-14 on substance use residential discharge planning, dated Oct 14, 2026. | 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 |
| 2026-09-01 | LDH Bulletin 26-12: Healthy Blue's Medicaid contract ends 12/31/2026; members choose a new MCO 10/15 to 11/16/2026 or are auto-assigned effective 1/1/2027; prior authorizations honored up to 60 days. | Source |
| 2026-07-10 | LDH Bulletin 26-10: off-cycle Medicaid provider revalidation for selected provider types including Mental Health Rehabilitation, run through Gainwell; missing a due date deactivates the provider. | Source |
| 2026-07-10 | LDH Bulletin 19-3 revised: Medicaid provider issue resolution, with 180-day reconsideration, 90-day appeal and independent review steps, and MCO provider contacts. | Source |
| 2026-06-01 | Act 770 (SB 465, 2026 Regular Session), signed by the Governor per the legislature's bill page, changes commercial health claim payment deadlines and the recoupment window; the enrolled text says it takes effect January 1, 2027. | Source |
| 2026-04-01 | UnitedHealthcare Community Plan left Louisiana Medicaid (participation ended 3/31/2026); members moved to the remaining MCOs. New claims still accepted within 365 days. | Source |
How do I bill mental health claims in Louisiana?
These answers come from the same sources as the rest of this Louisiana billing guide.
The Louisiana Department of Health (LDH) runs Louisiana Medicaid, branded Healthy Louisiana, and most members are enrolled in managed care organizations (MCOs) that also cover specialized behavioral health; Gainwell Technologies is the fee-for-service claims processor and enrollment vendor. LDH lists five MCOs (Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Humana Healthy Horizons in Louisiana, Louisiana Healthcare Connections); UnitedHealthcare Community Plan left on March 31, 2026, and Healthy Blue's contract ends December 31, 2026, so four MCOs are expected from January 1, 2027. Start with the member's payer type: Medicaid plan, Medicare Part B, a Blue Cross licensee or another commercial plan.
Questions about billing in Louisiana
How long do I have to file a Louisiana Medicaid behavioral health claim?
LDH's bulletins on the UnitedHealthcare and Healthy Blue transitions both say new claims are accepted under a 365-day timely filing period, and La. R.S. 46:442 says LDH cannot set a Medicaid filing window shorter than 365 days from the date of service. Each MCO has its own provider manual, so confirm the rule with the plan that holds the member.
Which Medicaid plans will I bill after January 1, 2027?
Healthy Blue's contract ends December 31, 2026, so its members move to one of the four remaining MCOs: Aetna Better Health, AmeriHealth Caritas Louisiana, Humana Healthy Horizons in Louisiana or Louisiana Healthcare Connections. Check the member's plan in the Medicaid eligibility system on each date of service, because MEVS is expected to show new assignments by November 23, 2026.
Who is the Blue Cross licensee in Louisiana, and how long does it allow for filing?
Blue Cross and Blue Shield of Louisiana, branded Louisiana Blue, is the independent licensee. Its November 2025 behavioral health webinar lists 15 months from the date of service (or the length in the member's contract) for most products, 12 months for Blue Advantage and OGB, and says self-funded and BlueCard claims vary.
How do I bill Louisiana Medicaid telehealth for therapy or psychiatry?
LDH Bulletin 25-28, revised October 20, 2025, says Medicaid telemedicine claims need modifier 95 with place of service 02 or 10, and are paid at the same rate as in-person services. The bulletin sends behavioral health providers to the Behavioral Health Services Provider Manual and the Specialized Behavioral Health Fee Schedule, so confirm details with the member's MCO.
Does MCM South bill for practices in Louisiana?
MCM South currently serves ten states; request a quote to ask about Louisiana.
Sources for the Louisiana billing guide
Last checked October 25, 2026. Every source below was opened and read on that date.
- LDH Informational Bulletin 19-3, checked October 25, 2026
- LDH Informational Bulletin 26-12 (Healthy Blue transition, 9/1/2026), checked October 25, 2026
- LDH Informational Bulletin 26-3 (UnitedHealthcare transition, rev. 3/6/2026), checked October 25, 2026
- LDH Informational Bulletin 26-10 (off-cycle revalidation, 7/10/2026), checked October 25, 2026
- LDH Informational Bulletin 15-13 (identifying enrollee's plan, rev. 5/12/2026), checked October 25, 2026
- LDH Informational Bulletin 25-28 (telemedicine, rev. 10/20/2025), checked October 25, 2026
- LDH Informational Bulletin 16-3 (behavioral health billing, rev. 9/1/2017), checked October 25, 2026
- LDH Informational Bulletin 21-5 (provider enrollment portal, rev. 7/28/2021), checked October 25, 2026
- LDH Informational Bulletins index, checked October 25, 2026
- LDH For Medicaid Providers page, checked October 25, 2026
- LDH Medicaid Work Requirements page, checked October 25, 2026
- LDH HR1 General Toolkit (March 2026), checked October 25, 2026
- LDH news 12/12/2025: Medicaid managed care contracts for 2026, 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
- Georgia insurance companies contact guide
- Texas insurance companies contact guide
- Florida insurance companies contact guide
- Tennessee insurance companies contact guide
Billing in Louisiana? 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 Louisiana.
MCM South currently serves practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.