Virtual Credit Card Payments for Therapists: What to Check Before You Run the Card
Virtual credit card payments for therapists are one-time card numbers that an insurer, or the company paying on its behalf, sends instead of a bank deposit. They look like good news until you run the card and see the fee come out of the payment. This guide explains what a virtual card is, what to check before you process it, and how to ask for a direct deposit instead. It is operational guidance, not legal advice.
What a virtual credit card payment is
A virtual credit card payment is a single-use card number sent to your practice to pay one claim or a batch of claims. You enter it into your own card terminal or processor, just as you would charge a client. The money then arrives like any card sale, minus your processor’s fee.
Two terms matter here. An EFT (electronic funds transfer) is a direct deposit from the payer to your bank account. An ERA (electronic remittance advice) is the electronic explanation of payment that tells you which claims were paid, adjusted or denied. The Centers for Medicare & Medicaid Services (CMS) EFT and ERA page describes the federal standards for both: the NACHA (bank network rules group) CCD+Addenda format for EFT and the X12 835 for ERA.
Why a practice receives one
A practice receives a virtual card when a payer or its payment vendor sends card payments by default instead of EFT. In practice, virtual credit card payments for therapists usually start for one simple reason: you never enrolled in EFT with that payer, so the vendor used another method. The rules also vary by payer, so check each one separately.
The good news is that you have a say. A 2017 CMS FAQ on EFT says health plans cannot require providers to accept virtual card payments, and neither can their payment vendors. It also says a plan must honor a provider’s request for EFT through the ACH (Automated Clearing House) network. Rules and enforcement can change, so treat that FAQ as a starting point and confirm with each payer.
What it costs and what to check
The cost of virtual credit card payments for therapists is the processing fee your own merchant agreement sets. That fee is taken from the amount the insurer paid, so your deposit is lower than the amount on the remittance. We will not guess at an amount here, because it depends on your processor and your contract.
Check these things on every card payment:
- Amount to the cent. Compare the card amount to the ERA or paper remittance before you run it.
- Expiration and limit. Many cards are valid only for a short time and only for the exact amount. Run it before it expires.
- Your processor’s fee. Record it as a processing expense, not as a payer reduction.
- Posting. Post the full payment to the claim, then record the fee separately, so your adjustments and your clean claim rate reports stay accurate.
- Vendor charges. The same FAQ notes that optional add-on services from a payment vendor may carry fees, and you do not have to buy them. Read any contract before you sign.
How to ask for EFT and ERA instead
To switch, you enroll in EFT and ERA with the payer or its payment vendor. CMS encourages providers to enroll for both with each plan they work with. You will usually need your practice’s Tax Identification Number (TIN) and each clinician’s National Provider Identifier (NPI).
- Find the payer’s provider portal page for electronic payment or EFT and ERA enrollment.
- Complete the enrollment form with your bank details and TIN.
- Ask whether the payer has an opt-out from card payment, and in what form.
- Tell your clearinghouse (the company that moves your claims and remittances) so ERAs route to the right place.
- Watch the next payment. Confirm it arrives by EFT and that the ERA matches.
The CAQH CORE payment and remittance operating rules include enrollment data rules for EFT and ERA, which is why many payer enrollment forms ask for similar information. CAQH now points that page to its DataSpring site.
Are Blue Cross plans and other private payers all the same?
No. Each payer sets its own payment-method process, and Blue Cross Blue Shield is a federation of independent licensees, so one plan’s steps do not apply to another. Start with the payer’s own provider page and use the Blue Cross guides to find the right licensee. Medicare and Medicaid have separate enrollment processes through their own contractors and state agencies, so do not assume a commercial answer applies.
What to do Monday morning
These five steps keep virtual credit card payments for therapists from slipping past your posting process.
- Pull the last 30 days of payments and mark which ones came as cards.
- List the payers behind them and rank by volume. Start with your top three.
- Record each card fee as its own line.
- Request EFT and ERA enrollment from those three payers.
- Update your posting rule so a card payment is flagged for review.
Questions to verify with the payer
- Can you switch our practice to EFT and ERA, and what form do you need?
- Is there an opt-out for virtual card payments, and does it apply to all of our locations?
- Does your payment vendor charge us anything on its side?
- Will the ERA come through our clearinghouse, and how will it match the deposit?
- How long will the card stay valid after it is issued?
How MCM South helps with virtual credit card payments for therapists
MCM South bills for psychotherapists and psychiatrists, including out-of-network claims for clients. On the billing side, we help with tracking claim status and working denials, so payments and remittances line up. We do not give legal advice. Learn more about our behavioral health billing services.
Where MCM South works
MCM South works with psychotherapists and psychiatrists in ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. See insurance company contacts by state, who we serve and the state billing guides. This post is operational guidance for billing, not legal advice.
The short version: virtual credit card payments for therapists
Insurers sometimes pay by virtual card, and you can usually ask for EFT and ERA instead. Check the amount, expiration and your own processor fee on virtual credit card payments for therapists before you run the card. More guides are in Resources.
Sources checked (November 2, 2026)
- CMS Operating Rules: EFT and Remittance Advice
- CMS EFT FAQ (Nov 2017, hosted by NUBC)
- CAQH CORE Operating Rules (DataSpring)
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Related reading
Frequently asked questions
What is a virtual credit card payment from an insurance company?
It is a single-use card number sent to your practice to pay a claim instead of a direct deposit (EFT) or a check. You run it through your own card processor, which may charge you a fee.
Do I have to accept a virtual credit card payment from a payer?
A 2017 CMS FAQ says health plans and their payment vendors cannot require providers to accept virtual card payments, and that a plan must honor a provider’s request for EFT. Confirm the current process with each payer.
Is the processing fee on a virtual card payment deductible from what the insurer owes me?
No. The fee comes from your own merchant agreement, so you absorb it. Record it separately from the payment and do not treat it as a payer adjustment.
How do I switch a payer to EFT and ERA?
Find the payer’s electronic payment enrollment page, submit your TIN, NPIs and bank details, ask about any card opt-out, and tell your clearinghouse. Then confirm the next payment arrives by EFT with a matching ERA.
