Georgia Medicare Part B for Therapists and Psychiatrists
Georgia Medicare Part B covers outpatient mental health care for people on Medicare, and it pays psychiatrists, psychologists and other licensed clinicians who enroll. This guide explains who can bill, how enrollment works, what the telehealth rules look like through 2027 and how long you have to file a claim. Status is current as of October 15, 2026. Check each CMS page before you act. This is operational guidance, not legal advice.
Billing on your own? See our guide to solo therapist billing in Georgia.
Who processes Georgia Medicare Part B claims
Georgia Medicare Part B claims go to one Medicare Administrative Contractor (MAC). Palmetto GBA is the MAC for Georgia, in Jurisdiction J with Alabama and Tennessee, according to the CMS provider contact table. A MAC enrolls providers, processes claims and issues your PTAN (Provider Transaction Access Number), per the CMS FAQ for marriage and family therapists and mental health counselors. You bill under your NPI (National Provider Identifier). Our Georgia insurance companies contact guide lists the Palmetto GBA contact line and the numbers for private insurers.
Who can bill Georgia Medicare Part B for mental health
Medicare.gov lists these providers of covered outpatient mental health services: psychiatrists and other doctors, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, marriage and family therapists (MFTs) and mental health counselors (MHCs). See Medicare.gov outpatient mental health coverage.
MFTs and MHCs have been able to bill Medicare directly since January 1, 2024. CMS pays them 75 percent of the clinical psychologist rate under the Physician Fee Schedule. They need a master’s or doctoral degree that qualifies for state licensure, at least two years or 3,000 hours of supervised post-master’s clinical experience and a state license. See the CMS MFT and MHC page.
How to enroll for Georgia Medicare Part B
CMS lists four steps on its provider enrollment page:
- Get an NPI through NPPES.
- Complete the application in PECOS, or use a paper application if you cannot apply online. Individual practitioners use the CMS-855I.
- Pay the application fee, if one applies. CMS says MFT and MHC enrollment carries no fee.
- Work with your MAC, which may ask for more information.
You need a separate Medicare application for each state where you give services. Report a change of practice location within 30 days and other changes within 90 days. Medicaid enrollment does not carry over to Medicare, so our Georgia Medicaid provider enrollment guide is a separate task.
Telehealth under Georgia Medicare Part B through 2027
CMS says Medicare telehealth flexibilities run through December 31, 2027. Until then, patients can receive telehealth anywhere in the U.S., including at home, and audio-only in the home is allowed. See the CMS Telehealth FAQ, updated October 9, 2026.
Mental health telehealth has an in-person rule that starts after December 31, 2027:
- An in-person visit within 6 months before the first mental health telehealth service.
- At least one in-person visit every 12 months after that.
- From January 1, 2028, audio-only for home behavioral health is allowed only if the clinician can use video and the patient cannot or does not consent to video.
Patients who start mental health telehealth at home on or before December 31, 2027 are treated as established. Plan your schedule now, because rules can change again.
Filing limits, coinsurance and Medicare Advantage
Medicare denies a claim as late if it arrives more than 12 months after the date of service, per the CMS Claims Processing Manual, Chapter 1. Exceptions exist, such as administrative error. After the Part B deductible, the patient pays 20 percent of the Medicare-approved amount, according to Medicare.gov.
Medicare Advantage plans from Aetna, Humana or UnitedHealthcare are private plans. Call the number on the member card for those, and follow the plan’s contract. Medicare, Medicaid and private insurers follow different rules, so keep them in separate workflows.
Where MCM South helps
MCM South Medical Billing Service bills for psychotherapists and psychiatrists. We currently serve practices in Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. If Georgia Medicare Part B billing is slowing your practice, get a free quote or schedule a consultation.
Keep learning: the insurance companies contact by state directory, the CPT and E/M code guide, the billing terms glossary, insurance credentialing, credentialing and network status, our page on credentialed vs. noncredentialed with insurance and the mental health billing FAQ.
FAQs
Who processes Georgia Medicare Part B claims?
Palmetto GBA is the Medicare Administrative Contractor for Georgia, in Jurisdiction J, per the CMS provider contact table.
Can an LMFT or counselor bill Georgia Medicare Part B?
Yes. MFTs and mental health counselors have been able to enroll and bill Medicare directly since January 1, 2024 if they meet the CMS requirements and state licensure.
How long do I have to file a Georgia Medicare Part B claim?
Claims must reach the MAC within 12 months of the date of service, with limited exceptions under CMS rules.
Is Medicare telehealth for therapy still covered in Georgia?
CMS says flexibilities run through December 31, 2027, with a new in-person visit rule for mental health telehealth after that date.
