Tennessee Medicare Part B: 6 Easy Steps for Therapists
Tennessee Medicare Part B covers outpatient mental health care for people on traditional Medicare, and Palmetto GBA runs the program in your state. This guide shows who can bill, how to enroll, where telehealth stands, and how long you have to file. Status is current as of October 17, 2026. This is operational guidance, not legal advice.
Medicare rules are federal. Private payers and TennCare, Tennessee’s Medicaid program, follow separate rules, so we label each one. Confirm the linked CMS pages before you act.
Who processes Tennessee Medicare Part B claims
Palmetto GBA, LLC is the Medicare Administrative Contractor (MAC) for Jurisdiction J, which covers Alabama, Georgia, and Tennessee. CMS lists it as the A/B MAC for Part A and Part B fee-for-service claims in those states. Its CMS contractor page shows a contract running to August 2031.
Medicare Advantage plans are run by private insurers, not Palmetto. Check each plan’s own manual. For commercial plans, see our Tennessee insurance companies contact guide.
Who can bill Tennessee Medicare Part B for mental health
Medicare rule. The March 2026 CMS mental health booklet (MLN1986542) lists psychiatrists (MDs and DOs), clinical psychologists, clinical social workers, nurse practitioners, clinical nurse specialists, and physician assistants. Since January 1, 2024, marriage and family therapists (MFTs) and mental health counselors (MHCs) can enroll and bill on their own.
MFTs and MHCs need a qualifying graduate degree, two years or 3,000 hours of supervised post-degree experience, and state licensure or certification. Medicare pays them 75% of the clinical psychologist rate, per the CMS MFT and MHC page.
Social workers, MFTs, MHCs, and nurse practitioners must accept assignment, which means taking the Medicare-allowed amount as payment in full. Clinical psychologists get full payment only when they accept it. Behavioral health incident-to services can run under general supervision, but social workers, MFTs, and MHCs cannot bill their own incident-to services. Providers who opt out cannot also enroll, and an opt-out lasts two years, per the CMS enrollment page.
How to enroll for Tennessee Medicare Part B in 6 steps
- Get a National Provider Identifier (NPI). The CMS-855I form says you must have one before you enroll.
- Confirm your degree, hours, and Tennessee license meet CMS rules for your provider type.
- Apply in PECOS (Provider Enrollment, Chain and Ownership System) or on paper. CMS says PECOS applications process faster.
- Report reassignment of benefits on the same CMS-855I if a group will be paid for your services.
- Match your name, tax ID, and NPI data exactly across NPPES and PECOS, then work with Palmetto on any fixes.
- Send claims electronically on the 837P. The CMS-1500 is allowed only in certain situations.
Private payer note. Medicare enrollment does not credential you with commercial plans. Read in-network vs out-of-network first, and see our credentialing service page.
Telehealth under Tennessee Medicare Part B through 2027
- Behavioral health telehealth can be delivered to a patient at home, with no geographic limit.
- Audio-only is allowed at home through December 31, 2027.
- An in-person visit requirement for mental health telehealth begins January 1, 2028. Patients who start at home on or before December 31, 2027 are treated as established and need an in-person visit every 12 months.
Details are in the CMS telehealth FAQ.
Filing limits for Tennessee Medicare Part B
Medicare denies a claim received more than 12 months after the service date, per the Claims Processing Manual transmittal (Section 70.4). Narrow exceptions exist under 42 CFR 424.44(b). File early.
Practical tips for Tennessee Medicare Part B
Start your Tennessee Medicare Part B enrollment before you schedule your first Medicare patient. Keep one folder with your NPI, license, and PECOS confirmation. Set a calendar alert at 10 months for any unpaid claim. Review telehealth rules each quarter, because the 2028 changes are close.
Where MCM South helps
MCM South Medical Billing Service, LLC bills for psychotherapists and psychiatrists in ten currently served states: GA, MA, CT, TX, FL, NY, CO, TN, NC, and IL. We handle in-network and out-of-network claims. Get a Free Quote or Schedule a Consultation.
Keep learning: compare the Texas, Florida, and Massachusetts Medicare Part B guides, then see Tennessee Medicaid billing, the State & Regional Billing Guides, the Billing Terms Glossary, and all Resources.
More from MCM South: Medicare Part B glossary entry; timely filing glossary entry.
FAQs
Who handles Tennessee Medicare Part B claims?
Palmetto GBA, LLC, the Jurisdiction J contractor for Alabama, Georgia, and Tennessee.
Can a counselor or family therapist bill Tennessee Medicare Part B?
Yes, if they meet CMS requirements for an MFT or MHC, hold state licensure, and enroll. Since January 1, 2024 they bill independently.
How long do I have to file a Tennessee Medicare Part B claim?
Twelve months from the date of service. Claims received later are denied unless an exception applies.
Is telehealth covered for Medicare patients in Tennessee?
Yes. Mental health telehealth at home is covered, with audio-only allowed through 2027 and in-person rules starting in 2028.
