Central Texas Mental Health Billing Service: 6 Easy Checks
A Central Texas mental health billing service is an outside company that files insurance claims for therapy and psychiatry practices in the Austin area and the towns around it, then posts payments and follows up on denials. Central Texas is a mix of one large Medicaid service area and a rural one, so the plan a client has changes how you bill. This guide covers the payer rules and six checks to run before you hire.
What a Central Texas mental health billing service handles
A Central Texas mental health billing service covers benefit checks, claim submission, payment posting and denial follow-up. It does not choose your codes or write your notes.
For Texas Medicaid, the Texas Medicaid and Healthcare Partnership (TMHP) managed care handbook says managed care claims go to the plan the client was enrolled in on the date of service and must arrive within 95 days.
The Texas Health and Human Services Commission (HHSC) lists plans by service area on its managed care service areas map (revised January 2026). Travis is its own service area. HHSC’s handbook appendix lists Travis, Williamson, Hays, Bastrop, Burnet, Caldwell, Fayette and Lee in it. Counties such as Bell, McLennan and Brazos fall into the Medicaid Rural Service Area (MRSA) Central.
| Service area | STAR plans | STAR+PLUS plans |
|---|---|---|
| Travis | Blue Cross and Blue Shield of Texas, Superior, Dell Children’s | Superior, United |
| MRSA Central | RightCare (Scott and White), Superior, Wellpoint | Superior, United |
Look up your own county in HHSC’s appendix before you rely on this table. Check the client’s plan at every visit, because enrollment can change.
Rules for a Central Texas mental health billing service, by payer type
Private, public and state rules run on different clocks. Keep them apart in your billing notes.
Private payers
Blue Cross and Blue Shield of Texas (BCBSTX) is a division of Health Care Service Corporation and an independent Blue Cross and Blue Shield licensee. Its commercial PPO provider manual (updated December 19, 2025) says plan claims are due within 365 days of the date of service. Its Medicaid claims page says 95 days.
Those are two different programs from one company, which is why you should read the rule for the product on the card.
The Texas Department of Insurance (TDI) says providers generally have 95 days to file with a managed care carrier unless the contract extends the time, and self-funded employer plans are exempt.
Build your payer list from your own remittances, since each carrier follows its own manual. See payer contract compliance for what to track.
Medicare and Medicaid
Medicare.gov says providers file Original Medicare claims within 12 months of the date of service. CMS says Novitas Solutions won the Jurisdiction H contract, which includes Texas (announced June 24, 2026). For Texas Medicaid, the behavioral health handbook says licensed professional counselors, marriage and family therapists, clinical social workers and psychologists must be enrolled in Medicare or hold a pediatric practice exemption.
Most psychotherapy codes are limited to 30 visits per calendar year before prior authorization.
State rules
TDI’s parity overview (updated December 15, 2025) says fully insured plans must cover mental health at parity with medical benefits. A card marked “TDI” or “DOI” generally points to a fully insured plan. Texas Insurance Code section 1455.004 (read the section) says covered plans cannot set higher cost-sharing for telehealth than for in-person care, with an audio-only exception.
How do I choose a Central Texas mental health billing service?
Choose a Central Texas mental health billing service by asking every candidate the same six questions and getting the answers in writing. Ask what the service charges and exactly what that covers, but do not accept a figure without the terms behind it.
| Check | What to ask |
|---|---|
| 1. Specialty | Do you bill only mental and behavioral health, including psychiatric E/M plus add-on codes? |
| 2. Fees in writing | How are you paid, what does it cover, and what costs extra? |
| 3. Eligibility | Who checks benefits before the first visit? See eligibility verification. |
| 4. Credentialing | Who handles enrollment? See insurance credentialing for therapists. |
| 5. Reports | Will I see my clean claim rate and denials each month? |
| 6. Exit | What do I get back if I leave? |
What to do Monday morning
Use this list to start your Central Texas mental health billing service search on solid ground.
- Export unpaid claims with payer and date of service.
- Mark each Blue Cross and Blue Shield of Texas claim as commercial or Medicaid, because the filing windows differ.
- Check Medicaid claims against the plan on the date of service.
- Read recent payments against the electronic remittance advice.
- Send the six questions to two services and compare the answers.
The short version: Central Texas mental health billing service
A Central Texas mental health billing service should know that BCBSTX commercial and Medicaid claims run on different clocks, which Medicaid plans serve Travis and the rural counties, and your Medicare rules. Ask the six questions and get the terms in writing.
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, and we bill out-of-network claims for clients. Payer enrollment is a separate job, covered on our credentialing page.
Keep going
Related reading
Ready to hand off the billing side? We can talk through your practice.
FAQ
Do BCBSTX commercial and Medicaid claims have the same filing deadline?
No. The BCBSTX commercial PPO manual says 365 days from the date of service, and its Medicaid claims page says 95 days. Check which product the member has before you set the deadline.
Which Medicaid plans serve Austin?
HHSC’s January 2026 map lists Blue Cross and Blue Shield of Texas, Superior and Dell Children’s for STAR in the Travis service area, and Superior and United for STAR+PLUS. Plans change, so verify each client on the date of service.
Does the TDI 95-day rule apply to every plan?
No. TDI says it applies generally to managed care carriers, contracts can extend it, and self-funded plans, Medicaid, CHIP and Medicare Advantage are exempt from the TDI rule.
Can a billing service submit out-of-network claims?
Many can, but confirm it. MCM South bills out-of-network claims for clients.
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.
