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Built for solo therapists, psychiatrists and group practices
Alabama Billing Guide for Mental Health Therapists and Psychiatrists
Pick your region, choose who pays you, then follow six steps from first visit to payment. Every fact below links to its official source.
- MedicaidAlabama Medicaid enrolls psychologists and behavioral health providers through its fiscal agent, Gainwell, and generally requires claims within one year of the date of service.
- Medicare Part BClaims in Alabama go to Palmetto GBA, the Medicare Administrative Contractor for Jurisdiction J.
- Blue Cross Blue ShieldBlue Cross and Blue Shield of Alabama is the Blue licensee in Alabama. Its rules apply to its own plans only.
- LawState law can change how you bill, including the 30-day clean claim payment rule. Alabama law that changes billing.
Where do you practice?
Alabama payers and Medicaid plans follow where your clients live and which plan they carry. Pick a city to see what to check there and jump to its local guide when one is published.
Map data © OpenStreetMap contributors. Pins mark approximate city locations.
Who pays you?
Rules differ by payer type. Choose one to see what to know, what to do, and where to read more.
Follow one claim, six steps
Most denials trace back to one of these steps. Click a step for what to do this Monday.
Your Monday checklist
Check items off as you go. Your progress stays on this device only.
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This Alabama billing guide covers Medicaid, Medicare, Blue Cross and Blue Shield of Alabama, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
Alabama billing guide: how Alabama pays for outpatient care
Alabama Medicaid enrolls psychologists and behavioral health providers through its fiscal agent, Gainwell, and generally requires claims within one year of the date of service. Medicare Part B claims in Alabama go to Palmetto GBA, the contractor for Jurisdiction J. Blue Cross and Blue Shield of Alabama is the Blue licensee, and Alabama Code section 27-1-17 sets prompt-pay deadlines for most private insurers.
Keep the payer types apart. A client with commercial coverage, Medicaid and Medicare can sit on the same schedule, and each follows different rules. Start with the card in the client's hand, then check the payer's own provider site. For the codes behind each claim, see our mental health CPT codes guide, and for provider numbers see the Alabama insurance companies contact guide.
Alabama Medicaid: enrollment and filing limits for behavioral health
Alabama Medicaid generally requires claims within one year of the date of service, though some programs have different limits. A claim for a retroactive eligibility period may be processed if the fiscal agent receives it within one year of the retroactive award.
See the Alabama Medicaid billing FAQ for the filing rule and the retroactive eligibility exception.
Who enrolls and how
Gainwell enrolls psychologists and behavioral health providers and issues provider contracts to applicants who meet the licensure and certification rules. Behavioral health providers are assigned provider type 07, and licensed professional counselors carry specialty 070. The rules are in Chapter 34 of the Alabama Medicaid Provider Manual.
- Psychologists and the allied mental health professionals who work for them need an Alabama Medicaid supervision contract on file, completed for each allied professional who bills under the psychologist's NPI.
- Since January 1, 2024, licensed marriage and family therapists and licensed professional counselors can enroll with Alabama Medicaid to provide behavioral health services in federally qualified health centers and rural health clinics.
- Community mental health rehabilitative services fall under Chapter 47 of the Alabama Medicaid Administrative Code and involve Alabama Department of Mental Health certification. That is a separate path from enrolling as an individual psychologist or counselor.
Confirm your enrollment and the member's coverage before you bill. Our credentialing and network status guide explains how enrollment and network status differ.
Medicare Part B in Alabama
CMS lists Palmetto GBA as the Medicare Administrative Contractor for Jurisdiction J, which covers Alabama, Georgia and Tennessee.
Medicare fee-for-service claims must be filed within 12 months of the date of service, with limited exceptions. See the CMS instruction on time limits for filing claims. File early, because a claim that misses the window is hard to recover, and track every claim until it pays. Our claim denials and appeals guide covers what to do when one is denied.
Blue Cross and Blue Shield of Alabama
Blue Cross plans are independent licensees. Blue Cross and Blue Shield of Alabama is the Blue licensee in Alabama, and its rules apply to its own plans only.
The Blue Cross Blue Shield Association lists the licensees by area. Never assume one licensee's rules work like another's. Check the plan name and prefix on the client's card, then read the plan's own provider manual for timely filing and appeal windows. Third-party lists of Blue Cross filing limits often disagree, so rely on the plan's own site. Our Blue Cross Blue Shield of Alabama guide and our Alabama Blue Cross behavioral health billing post cover the plan in more detail.
Other private payers and EAPs
Aetna, Cigna (Evernorth Behavioral Health), UnitedHealthcare, Humana and employee assistance programs each publish their own provider sites, fee schedules and filing limits. Employee assistance programs often cap the number of visits and bill through a separate channel, so verify the benefit before the first session.
- Verify benefits for every new client before the first session.
- Record the deductible, copay or coinsurance, and visit limits.
- Submit claims electronically and track each one until it pays.
- For out-of-network clients, read in-network vs out-of-network credentialing and our guide to out-of-network billing for therapists.
Alabama law that changes billing
Alabama Code section 27-1-17 requires insurers to pay a clean electronic claim within 30 calendar days of receipt and a clean written claim within 45 calendar days.
- If an insurer denies or pends a claim, it must notify the provider within the same 30 or 45 days of the reason and of any additional information needed. Any undisputed portion must still be paid on schedule.
- A clean claim that is overdue accrues interest at 1.5 percent a month, prorated daily.
- The section covers insurers, health service corporations and health benefit plans that issue or renew accident or health policies, including out-of-state insurers that process claims for Alabama residents or services received in Alabama.
- It excludes Alabama Medicaid Agency claims and Medicare claims, and it applies to claims-based payment, not capitation.
This is operational guidance for a billing service, not legal advice. Confirm how the rule applies to a specific contract with the Alabama Department of Insurance or your counsel.
Codes and rates
Psychotherapy, evaluation and management, and add-on codes follow CPT rules in every state, but coverage, rendering-provider rules and rates differ by payer. Alabama Medicaid publishes its own provider manual and fee information, so check them before you assume a commercial rule applies. Our mental health CPT codes guide explains the codes, and the billing terms glossary defines the terms.
What changed
- January 1, 2024: Alabama Medicaid opened enrollment to licensed marriage and family therapists and licensed professional counselors in federally qualified health centers and rural health clinics.
- July 1, 2026: The Alabama Department of Mental Health published a comprehensive provider manual for certified community behavioral health clinics. It matters to clinics, not to most solo practices.
Rules change, so check the Medicaid Agency's provider alerts and your payers' bulletins before you rely on any date here.
How do I bill mental health claims in Alabama?
These answers come from the same sources as the rest of this Alabama billing guide.
Start with the member's payer type: Alabama Medicaid, Medicare Part B, Blue Cross and Blue Shield of Alabama or another commercial plan. Then use that payer's own filing limit and provider manual, and track every claim until it pays.
Questions about billing in Alabama
How long do I have to bill Alabama Medicaid?
Alabama Medicaid generally requires claims within one year of the date of service, though some programs have different limits. A claim for a retroactive eligibility period may be processed if the fiscal agent receives it within one year of the retroactive award.
Who is the Medicare contractor for Alabama?
CMS lists Palmetto GBA as the Medicare Administrative Contractor for Jurisdiction J, which includes Alabama, Georgia and Tennessee. Medicare fee-for-service claims must be filed within 12 months of the date of service, with limited exceptions.
How fast must Alabama insurers pay a clean claim?
Under Alabama Code section 27-1-17, insurers must pay a clean electronic claim within 30 calendar days of receipt and a clean written claim within 45 calendar days, and owe interest of 1.5 percent a month on a late clean claim. The section excludes Alabama Medicaid and Medicare claims.
What is the Blue Cross filing limit in Alabama?
Blue Cross and Blue Shield of Alabama sets its own timely filing and appeal windows in its provider manual, and contracts can differ. Read them on the plan's provider site before you bill instead of relying on a third-party list.
Does a psychologist need a supervision contract for Alabama Medicaid?
Psychologists and the allied mental health professionals who work for them need an Alabama Medicaid supervision contract on file for each allied professional who bills under the psychologist's NPI.
Sources for the Alabama billing guide
Last checked November 13, 2026. Each source below is the official page for its rule. Check it again before you rely on a deadline.
- Alabama Medicaid billing FAQ (opened November 13, 2026)
- Alabama Code section 27-1-17 (Justia) (opened November 13, 2026)
- Alabama Medicaid Provider Manual, Chapter 34 (excerpt read in search results November 13, 2026)
- CMS: A/B MAC Jurisdiction J (read in search results November 13, 2026)
- CMS instruction on Medicare time limits for filing claims (linked from our other state guides)
- Blue Cross and Blue Shield of Alabama (link not yet opened)
- Blue Cross Blue Shield Association licensee list (linked from our other state guides)
- Alabama Department of Mental Health (read in search results November 13, 2026)
Billing in Alabama? 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 Alabama.
MCM South currently serves practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.