Texas Medicare Part B for Therapists and Psychiatrists
Texas Medicare Part B covers outpatient mental health care and pays psychiatrists, psychologists and other licensed clinicians who enroll. This guide explains who processes your claims, who can bill, how enrollment works, how long telehealth flexibilities last and how long you have to file. Status is current as of October 15, 2026. Confirm 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 Texas.
Who processes Texas Medicare Part B claims
Texas Medicare Part B claims go to one Medicare Administrative Contractor (MAC). Novitas Solutions is the MAC for Jurisdiction H, which covers Texas, Arkansas, Colorado, Louisiana, Mississippi, New Mexico and Oklahoma, according to CMS’s EDI help line list. CMS says your MAC is specific to the region where you practice and may ask for more information while it processes your application. Our Texas insurance companies contact guide lists the Novitas line and the private insurer numbers.
Who can bill Texas Medicare Part B for mental health
The CMS booklet Medicare and Mental Health Coverage, dated March 2026, lists these practitioner types: physicians, particularly psychiatrists; clinical psychologists; clinical social workers; clinical nurse specialists; nurse practitioners; physician assistants; marriage and family therapists; and mental health counselors. Each must meet its own qualifications.
Since January 1, 2024, marriage and family therapists (MFTs) and mental health counselors (MHCs) can bill Medicare independently. Part B pays them 75 percent of the clinical psychologist rate, and claims go in on the 837P. 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 experience and a state license. See the CMS MFT and MHC page.
How to enroll for Texas Medicare Part B
CMS lists four steps on its provider enrollment page:
- Get an NPI (National Provider Identifier) through NPPES.
- Complete the application in PECOS, or use a paper application if you cannot apply online.
- Pay the application fee if one applies.
- Work with your MAC.
For MFTs and MHCs, the CMS page adds a first step: register in the Identity and Access (I&A) system. It also says your effective enrollment date will be January 1 or later. After you enroll, report ownership changes, adverse legal actions and practice location changes within 30 days, and other changes within 90 days.
Telehealth under Texas Medicare Part B through 2027
The CMS Telehealth FAQ, updated October 9, 2026, says that through December 31, 2027, patients can receive Medicare telehealth anywhere in the U.S. Geographic and place-of-service limits for behavioral health were permanently removed, so patients can use telehealth at home.
- An in-person visit rule for mental health telehealth applies after December 31, 2027: one visit within 6 months before the first telehealth service.
- Patients already getting mental health telehealth at home before that date are treated as established, and need an in-person visit at least every 12 months after it.
- Audio-only in the home is allowed through December 31, 2027. After that, it is allowed for behavioral health only if the clinician can use video and the patient cannot or does not consent.
Filing limits for Texas Medicare Part B
Medicare denies a claim as late if it arrives more than 12 months after the date of service, measured from the “From” date, per the CMS Claims Processing Manual, Chapter 1. Exceptions include administrative error and retroactive entitlement. Medicare Advantage plans are private plans, so follow the member’s card and the plan contract. For the private insurer clocks, see our Texas prompt pay law guide.
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 Texas 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 Texas Medicare Part B claims?
Novitas Solutions is the Medicare Administrative Contractor for Jurisdiction H, which includes Texas.
Can an LPC or LMFT bill Texas Medicare Part B?
Yes. Mental health counselors and marriage and family therapists have been able to enroll and bill Medicare independently since January 1, 2024, if they meet the CMS and state licensure requirements.
How long do I have to file a Texas Medicare Part B claim?
Claims must reach the MAC within 12 months of the date of service, with limited exceptions.
Does Texas Medicare Part B cover telehealth for therapy?
CMS says flexibilities run through December 31, 2027, with a new in-person visit rule for mental health telehealth after that date.
