Blue Cross NC Behavioral Health Billing: 5 Easy Essentials
Blue Cross NC behavioral health billing is the process of enrolling with Blue Cross and Blue Shield of North Carolina and then getting mental health claims paid. Blue Cross NC is an independent Blue Cross Blue Shield licensee. It is not Anthem, and Elevance’s 2025 annual report does not list North Carolina among Anthem’s states.
Blue Cross NC behavioral health billing starts with credentialing
Credentialing is the review that confirms your education, license and history before a payer lets you in network. Blue Cross NC’s individual practitioner page (last modified August 10, 2026) lists four steps for professionals such as therapists, who hold a Type 1 National Provider Identifier (NPI). Follow them in order.
| Step | What you do |
|---|---|
| 1. CAQH profile | Complete and attest your CAQH ProView profile, then email your CAQH ID to . See our CAQH profile setup guide. |
| 2. Enrollment form | Submit the Individual Practitioner Enrollment form so Blue Cross NC can register your NPI. |
| 3. Blue e and EFT | After credentialing and enrollment are confirmed, register for the Blue e provider portal and set up electronic funds transfer (EFT). |
| 4. Agreement | You receive a Network Participation Agreement. If it does not arrive within 30 days, the page says to call 800-777-1643, option 6. |
Recredentialing starts as you near your three-year cycle. Keep your CAQH profile complete, current and attested. Our guide to credentialing and network status explains why a lapse can stop payment.
How do I get credentialed with Blue Cross NC for behavioral health?
Complete your CAQH profile, email the CAQH ID to Blue Cross NC’s credentialing team, submit the enrollment form and then register for Blue e. Do not bill in-network claims until you have the agreement and an effective date in writing. Blue Cross NC behavioral health billing before that date can lead to denials.
Private payers
For commercial Blue Cross NC behavioral health billing, the plan’s claims page lists three ways to submit. Enter a CMS-1500 form in Blue e, send electronic files (EDI) as a trading partner or through a clearinghouse, or mail the form to PO Box 35, Durham, NC 27702. The member’s Blue Cross NC ID must appear on every claim and attachment. The page does not state a filing deadline, a payer ID or appeal steps, so get those from your contract and the provider manual.
If you are out of network, claim rules differ. Our guide to in-network and out-of-network credentialing shows the split.
Telehealth in Blue Cross NC behavioral health billing
Blue Cross NC’s telehealth policy, effective January 1, 2023, says to report place of service (POS) 02 when the patient is outside the home and POS 10 when the patient is at home. Telehealth goes on professional claims and is paid at non-facility rates. Audio-only services are paid at 75 percent of the allowed amount, and claims need a modifier that shows the type of telehealth. See our guide to modifiers 93 and 95.
The policy covers fully insured and administrative-services-only plans, including the State Health Plan. It does not apply to providers outside North Carolina, and Medicare Advantage, Healthy Blue and the Federal Employee Program have their own documents. The page does not mention behavioral health by name, so read the corporate telehealth reimbursement policy before you bill. NASW North Carolina reports that behavioral health is among the covered categories.
Medicare and Medicaid
The rules above are for commercial plans. Medicare Advantage, Healthy Blue and the Federal Employee Program are separate products, and Blue Cross NC says their members follow their own plan documents. Check each product’s provider page before you apply a commercial rule.
State rules
North Carolina has a prompt-pay statute, G.S. 58-3-225, that sets how fast insurers must respond to claims and how late payments are handled. Read the current text with your counsel before you rely on a number. The statute applies to the plans it covers, so ask whether a given employer plan is fully insured.
A six-step checklist for Blue Cross NC behavioral health billing
- Update and re-attest your CAQH profile.
- Email your CAQH ID and submit the enrollment form.
- Register for Blue e and set up EFT.
- Use POS 02 or 10 and the right modifier on telehealth claims.
- Check prior approval requirements in Blue e before you schedule long courses of care.
- Log each claim and follow up on any claim that is still unpaid at day 30.
When a claim is denied, read the codes first, then use our service page for denied and rejected claims as a checklist for the appeal. The Blue Cross NC page lists a Provider Blue Line for mailed claims and an enrollment line for Blue e and EDI.
Our own pages cover Blue Cross NC billing details and North Carolina insurance contacts.
The short version: Blue Cross NC behavioral health billing
Blue Cross NC behavioral health billing needs a complete CAQH profile, a signed agreement, Blue e access, correct telehealth coding and a follow-up habit. Blue Cross NC is independent of Anthem, so use its own pages and your own contract.
How MCM South helps
MCM South Medical Billing Service, LLC bills exclusively for mental and behavioral health. We work with psychotherapists and psychiatrists in solo and medium-size practices in North Carolina and our other served states, and we bill out-of-network claims for clients.
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FAQ
Is Blue Cross NC the same as Anthem?
No. Blue Cross NC is an independent Blue Cross Blue Shield licensee, and Elevance’s annual report does not list North Carolina among Anthem’s states. Use Blue Cross NC’s own pages for rules.
How do I start credentialing with Blue Cross NC?
Complete and attest your CAQH profile, email the CAQH ID to Blue Cross NC’s credentialing team, and submit the Individual Practitioner Enrollment form. Register for Blue e and EFT after you get confirmation.
What place of service do I use for telehealth?
Under the policy effective January 1, 2023, use POS 02 when the patient is outside the home and POS 10 when the patient is at home. Add the modifier that shows the type of telehealth.
How are audio-only visits paid?
The 2023 policy pays audio-only services at 75 percent of the allowed amount. Read the current policy before you bill, because telehealth rules can change.
Where MCM South works
MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. We serve solo and medium-size practices that bill mental and behavioral health. Founder Michael Williams has worked with insurance payers in all 50 states. Browse the state and regional billing guides for rules that vary by state, or see our billing services.
This post is operational guidance for billing, not legal advice. Rules change, so confirm with the payer or your counsel.
