Tennessee Billing Guide for Mental Health Therapists and Psychiatrists
Who pays, where to enroll and which rules change your claims in Tennessee, for psychotherapists and psychiatric prescribers.
Last checked October 25, 2026. Reviewed against the official sources listed at the bottom of this page.
This Tennessee billing guide covers Medicaid, Medicare, Blue Cross, other private payers and state law for therapists and psychiatrists, with sources and a last-checked date.
Tennessee billing guide: how Tennessee pays for outpatient care
TennCare, Tennessee's Medicaid program, is run by the Division of TennCare and delivered through managed care organizations. You bill the member's plan: Wellpoint (formerly Amerigroup), BlueCare Tennessee or UnitedHealthcare Community Plan. Providers register with TennCare first and then credential with each plan.
TennCare's Behavioral Health Services Division oversees mental health and substance use services, and the plans publish behavioral health provider directories. Tennessee did not expand Medicaid, so the federal work requirement reaches only certain parents and caretakers, whom TennCare says it has already deemed compliant.
Who to bill, at a glance
| Payer type | Who you bill | Where to enroll or check rules |
|---|---|---|
| Medicaid (TennCare) | Division of TennCare; Wellpoint, BlueCare Tennessee and UnitedHealthcare Community Plan | TennCare health plans |
| Medicare Part B | Palmetto GBA, Jurisdiction J | CMS MAC page |
| Blue Cross Blue Shield | BlueCross BlueShield of Tennessee (independent, not Anthem) | See the Blue Cross section below |
Tennessee Medicaid: TennCare
This Tennessee billing guide starts with Medicaid, because it decides who pays and how you file.
TennCare is managed care. The state's health plan page lists Wellpoint, BlueCare Tennessee, UnitedHealthcare Community Plan and TennCare Select. Claims go to the member's plan.
No separate statewide behavioral health carve-out turned up on the TennCare pages we reviewed. TennCare says its Behavioral Health Services Division oversees mental health and substance use services and points members to the plans' behavioral health directories.
| Item | What to know |
|---|---|
| Agency | Division of TennCare |
| Provider registration | TennCare provider registration. Individual providers are added through CAQH ProView, and TennCare assigns the Medicaid ID after registration. |
| Behavioral health services | TennCare Behavioral Health Services |
| Wellpoint filing window | Wellpoint's October 2026 provider manual says to file within 120 days of the date of service, through the Availity EDI gateway. Corrected claims are due within 120 calendar days of the payment notice. Source |
| Prompt pay standard | TennCare's standard for plan claims is in Tenn. Code Ann. 56-32-126(b)(1): 90 percent of clean claims within 30 calendar days and 99.5 percent of provider claims within 60 calendar days. Source |
| Revalidation | TennCare staff gave off-cycle revalidation deadlines at the July 2026 Medicaid Advisory Committee: February 2027 for high-risk providers, June 2027 for other prioritized categories and June 2028 for all others. Source |
| Work requirement | TennCare says that beginning in 2027 federal law requires some members to meet work or community engagement requirements. In Tennessee that applies only to certain parents or caretakers, whom TennCare has already deemed compliant. Source |
Managed-care plans and carve-outs
| Plan or entity | Role in behavioral health |
|---|---|
| Wellpoint | Formerly Amerigroup. Provider manual dated October 2026. |
| BlueCare Tennessee | Check the plan's provider manual for its filing limits. |
| UnitedHealthcare Community Plan | Check the plan's current provider manual for its filing limits. |
| TennCare Select | Listed on the TennCare health plan page. |
Confirm each plan's behavioral health arrangement before you bill. Some plans may use a separate behavioral health vendor.
Medicare Part B in Tennessee
For Medicare, this Tennessee billing guide names your contractor and the current telehealth rules.
Medicare Part B pays for outpatient psychotherapy and psychiatric visits billed to the Medicare Administrative Contractor (MAC) for your state. CMS's July 14, 2026 fact sheet on the CY2027 Physician Fee Schedule proposed rule says the Consolidated Appropriations Act, 2026 extended telehealth payment authority through December 31, 2027, and proposes that in-person visit requirements for mental health visits not apply to services furnished through that date.
| Item | What to know |
|---|---|
| Contractor | Palmetto GBA, LLC |
| Jurisdiction | Jurisdiction J: Alabama, Georgia and Tennessee |
| Source | CMS.gov MAC page |
Blue Cross Blue Shield in Tennessee
This part of the Tennessee billing guide names the exact Blue Cross licensee, because Blue plans never share rules.
Blue Cross Blue Shield is a federation of independent companies, so one licensee's rules never apply to another. In Tennessee that is BlueCross BlueShield of Tennessee (BCBST). Its Provider Administration Manual says it is an independent licensee of the BlueCross BlueShield Association. It is not Anthem, and its rules do not apply to Blue plans in other states.
| Licensee | Parent or affiliation | Where it applies | Provider resources |
|---|---|---|---|
| BlueCross BlueShield of Tennessee | Independent licensee of the BlueCross BlueShield Association | Tennessee | BCBST Provider Administration Manual |
Other private payers and EAPs in Tennessee
The Tennessee billing guide also covers commercial plans and employee assistance programs.
These commercial payers and plan families most often matter for behavioral health billing in Tennessee. Check each payer's current provider manual before you submit.
| Payer | Behavioral health note | Provider resources |
|---|---|---|
| BlueCross BlueShield of Tennessee | The Provider Administration Manual sets commercial timely filing at six months from the date of service for individual providers, and 60 days when BCBST is secondary. It lists a Behavioral Health Network for commercial and Medicare Advantage. | Official page |
| Wellpoint (TennCare plan) | Wellpoint is a TennCare plan, not a commercial payer in this guide. Its manual lists behavioral health authorization contacts and a behavioral health services line. | Official page |
Tennessee billing guide: state law that changes billing
Use this section of the Tennessee billing guide to separate state law from payer policy.
State law sets the floor for commercial plans in Tennessee. Medicare and Medicaid rules are covered in their own sections above.
Mental health parity
Tenn. Code Ann. 56-7-2360, as amended by Public Chapter 244 (2021), requires individual and group plans from regulated carriers to cover mental health and substance use services in line with federal parity law. The Department of Commerce and Insurance enforces it and reports each year. Its 2026 report covers calendar year 2025. TDCI parity report
Telehealth in TennCare
A June 21, 2022 TennCare memo says providers must use place of service 02 or 10, or the telehealth modifier each plan requires (95, GT, GQ or G0). Confirm current plan rules. Memo
Medicaid prompt pay
Tenn. Code Ann. 56-32-126(b)(1) sets the standard for TennCare plans. TDCI
Practitioner scope: therapists and prescribers
Wellpoint's manual lists credentialed practitioner types, including psychologists, master's-level clinical social workers and psychiatric nurse practitioners. Source
Not legal advice. Confirm statute details with counsel.
Tennessee billing guide: codes and rates
This Tennessee billing guide lists only codes and rates confirmed on official pages.
These are the Tennessee-specific codes, modifiers and rate items confirmed on official pages. Medicare's own CY2027 conversion factor proposal is listed under What changed.
| Code or item | What to know |
|---|---|
| Telehealth place of service and modifiers | Use place of service 02 or 10, or the telehealth modifier the plan requires (95, GT, GQ or G0), per the June 2022 TennCare memo. Source |
| Wellpoint behavioral health authorization | The October 2026 manual lists separate fax lines for behavioral health inpatient, outpatient and neuropsychological testing authorizations, and a behavioral health services line. Inpatient authorizations can be submitted electronically on the Wellpoint provider site. Source |
Tennessee billing guide: what changed, newest first
Check this Tennessee billing guide update log before you rely on an older rule.
| Date | What changed | Source |
|---|---|---|
| 2027-01-01 | Federal Medicaid work requirement begins. In Tennessee it applies only to certain parents or caretakers, already deemed compliant. | Source |
| 2026-10-01 | Wellpoint Tennessee Medicaid provider manual, October 2026 edition: 120-day timely filing and the Availity EDI gateway. | Source |
| 2026-07-21 | TennCare Medicaid Advisory Committee: staff gave revalidation deadlines and said members need do nothing new for work requirements. | Source |
| 2026-07-14 | CMS released the CY2027 Medicare Physician Fee Schedule proposed rule: conversion factor $32.84 for non-qualifying APM participants (down 1.68%) and $33.17 for qualifying participants (down 1.19%). | Source |
| 2026-03-02 | TDCI published its 2026 Mental Health Parity Report. | Source |
How do I bill mental health claims in Tennessee?
These answers come from the same sources as the rest of this Tennessee billing guide.
Start with the member's payer type. For TennCare, bill the member's managed care plan, and check that plan's filing limit. Wellpoint's manual sets 120 days. Medicare Part B goes to Palmetto GBA in Jurisdiction J. BlueCross BlueShield of Tennessee is an independent Blue licensee and is not Anthem.
Questions about billing in Tennessee
Who do I bill for TennCare behavioral health claims?
Bill the member's plan: Wellpoint, BlueCare Tennessee or UnitedHealthcare Community Plan. Register with TennCare first.
What is the Wellpoint Tennessee timely filing limit?
120 days from the date of service, according to its October 2026 provider manual.
Is BlueCross BlueShield of Tennessee the same as Anthem?
No. BCBST says it is an independent licensee of the BlueCross BlueShield Association.
Does the Medicaid work requirement affect Tennessee?
TennCare says it applies only to certain parents and caretakers, whom it has already deemed compliant.
Does MCM South bill for practices in Tennessee?
MCM South serves Tennessee. Request a quote to talk through your practice.
Sources for the Tennessee billing guide
Last checked October 25, 2026. Every source below was opened and read on that date.
- Division of TennCare, checked October 25, 2026
- TennCare health plans, checked October 25, 2026
- TennCare Behavioral Health Services, checked October 25, 2026
- TennCare provider registration, checked October 25, 2026
- TennCare notices: community engagement, checked October 25, 2026
- TennCare Medicaid Advisory Committee minutes, July 2026, checked October 25, 2026
- TDCI TennCare prompt pay reports, checked October 25, 2026
- TDCI 2026 Mental Health Parity Report, checked October 25, 2026
- TennCare telehealth memo, June 2022, checked October 25, 2026
- Wellpoint Tennessee provider manual, checked October 25, 2026
- BCBST Provider Administration Manual, checked October 25, 2026
- CMS: MAC Jurisdiction J, checked October 25, 2026
- CMS: CY2027 Physician Fee Schedule proposed rule fact sheet, checked October 25, 2026
- CMS MAC jurisdiction page, checked October 25, 2026
Related guides
- State & Regional Billing Guides hub
- Tennessee insurance companies contact guide
- In-network vs out-of-network credentialing
- Credentialing and network status
- Blue Cross Blue Shield guide for Tennessee
- Tennessee Medicaid billing codes
- Mental health parity explained
- Medicaid managed care billing
- Medicare behavioral health billing
- Timely filing in the billing glossary
- Who we serve
- Georgia insurance companies contact guide
Billing in Tennessee? 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 serve Tennessee.
MCM South currently serves practices in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.