North Texas Mental Health Billing Service: 6 Easy Essentials
A North Texas mental health billing service is an outside company that sends insurance claims for therapy and psychiatry practices around Dallas and Fort Worth, posts the payments and chases denials. The work is the same everywhere in Texas, but your payer mix and Medicaid plan choices are local. This guide shows what changes in North Texas and six checks to run before you hire.
What a North Texas mental health billing service has to know
A good North Texas mental health billing service knows which payer owns each claim and which clock applies to it. In this region that means commercial plans, Texas Medicaid managed care plans and Medicare, each with its own filing rule. Texas Medicaid claims go to the plan the client was enrolled in on the date of service, per the Texas Medicaid and Healthcare Partnership (TMHP) managed care handbook.
The Texas Health and Human Services Commission (HHSC) sets Medicaid service areas, and Dallas and Tarrant are separate ones. The plans below come from HHSC’s managed care service areas map (revised January 2026).
| Service area | STAR plans | STAR+PLUS plans |
|---|---|---|
| Dallas | Molina, Parkland, Wellpoint | Molina, Superior, United |
| Tarrant | Aetna, Cook Children’s, Wellpoint | Molina, United |
STAR covers children, newborns, pregnant women and some families. STAR+PLUS covers adults with disabilities and adults 65 and older. A Molina service-area page lists Collin, Dallas and Rockwall counties under Dallas, and Denton, Parker and Tarrant counties under Tarrant. Verify the client’s plan on every visit, because enrollment can change.
Rules for a North Texas mental health billing service, by payer type
Keep the three rule sets apart. A deadline that is right for one payer type can be wrong for another.
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 PPO provider manual (updated December 19, 2025) says plan claims are due within 365 days of the date of service and encourages electronic filing through Availity. 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 that clean electronic claims are due payment in 30 days, paper in 45. Self-funded employer plans are exempt from those TDI rules. Build your payer list from your own remittances, since each carrier follows its own manual. Our guide to payer contract compliance shows what to track.
Medicare and Medicaid
Medicare.gov says providers file Original Medicare claims within 12 months of the date of service. CMS announced in June 2026 that Novitas Solutions won the Jurisdiction H contract, which includes Texas. For Texas Medicaid, the behavioral health handbook requires licensed professional counselors, marriage and family therapists, clinical social workers and psychologists to be enrolled in Medicare or hold a pediatric practice exemption. It limits most psychotherapy codes to 30 visits per calendar year before prior authorization. Managed care claims must reach the plan within 95 days.
State rules
TDI’s parity overview (updated December 15, 2025) says fully insured plans must cover mental health at parity with medical care and that TDI regulates those plans. A card marked “TDI” or “DOI” generally points to a fully insured plan. Texas Insurance Code section 1455.004 (read the section) requires covered plans to cover telehealth at the same level as in-person care and bars higher cost-sharing for it, with an audio-only exception.
How do I choose a North Texas mental health billing service?
Choose a North Texas mental health billing service by testing it on the same six questions you would ask any vendor, then check how it handles Texas payers specifically. Ask for answers in writing and ask to see a sample report before you sign.
| Essential | What to ask |
|---|---|
| 1. Specialty | Do you bill only mental and behavioral health, including psychiatry E/M plus add-on codes? |
| 2. Texas Medicaid | Do you bill the Dallas and Tarrant plans, and who tracks the 95-day rule? |
| 3. Eligibility | Who verifies benefits before the first visit? See eligibility verification. |
| 4. Credentialing | Who handles payer enrollment? See insurance credentialing for therapists. |
| 5. Reports | How do I see denials and my clean claim rate? |
| 6. Exit | What do I get back if I leave: claim history, portal access, reports? |
What to do Monday morning
These steps put your North Texas mental health billing service search on a clear footing.
- Export every unpaid claim with its payer and date of service.
- Write the filing window for each payer next to it, from the contract or manual.
- Mark Medicaid claims by plan and check that each went to the right plan.
- Read the electronic remittance advice for anything that paid short.
- Ask two services the six questions above and compare answers.
The short version: North Texas mental health billing service
A North Texas mental health billing service should know Texas payer clocks, the Dallas and Tarrant Medicaid plans and Medicare rules for your clinicians. Check specialty, Medicaid handling, eligibility, credentialing, reports and exit terms, and get the answers 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
Does the 95-day rule apply to every Texas plan?
No. TDI says providers generally have 95 days to file with a managed care carrier, but contracts can extend the time and self-funded plans, Medicaid, CHIP and Medicare Advantage are exempt from the TDI rule. The BCBSTX PPO manual says 365 days for its plan claims. Read the contract for each payer.
Do Dallas and Tarrant Medicaid claims go to the same plan?
No. Each client has a managed care plan, and the plans offered differ by service area. Bill the plan the client was enrolled in on the date of service and verify it each visit.
Which Medicare contractor handles Texas claims?
A CMS fact sheet from June 2026 says Novitas Solutions was awarded the Jurisdiction H contract, which includes Texas, with the new contract expected to take effect July 1, 2026. Confirm the current contractor on CMS.gov.
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.
