Getting in network can open your practice to far more clients, but credentialing is slow, paper-heavy and easy to lose track of. Here is how it works for therapists, step by step, and where most applications stall.
Key takeaways
- Start before you need the income. Credentialing commonly takes a few months, and sometimes longer.
- A current CAQH ProView profile, re-attested every 120 days, prevents many delays.
- Do not bill a payer for sessions before your effective date unless it confirms retroactive billing in writing.
1. Get your NPI and choose the right taxonomy
You need an individual (Type 1) NPI from NPPES. If you are forming a group practice, the group needs its own Type 2 NPI. Pick taxonomy codes that match your license, such as clinical social worker or mental health counselor, because payers cross-check them.
2. Build and maintain your CAQH ProView profile
Most commercial payers pull your credentials from CAQH ProView. Complete every section, upload your license, malpractice certificate and other documents, authorize the payers you are applying to, and re-attest every 120 days.
A lapsed attestation is one of the most common reasons an application silently stops moving.
3. Decide which payers to apply to
Look at the plans your current and prospective clients carry, and the large employers’ plans in your area. Then check who actually manages behavioral health for each plan. Many plans carve mental health out to a separate administrator, and that is where your application goes.
4. Submit complete applications
Each payer has its own application, portal or form. Before you submit, confirm that your CAQH profile is current, your documents are valid and your practice address and tax ID match everywhere. Record the date and any reference number.
5. Follow up on a schedule
Payers rarely tell you what is missing. Check the portal or call every couple of weeks, note who you spoke to and what they said, and answer requests quickly. Timelines vary a great deal by payer and state, so plan for months, not weeks.
Closed panels
If a payer says its panel is closed in your area, ask whether it makes exceptions, for example for bilingual clinicians, specific populations or underserved locations. If not, note a date to ask again.
Credentialing is a part-time job. Skip it.
Cure MB handles applications, CAQH upkeep and payer follow-up from intake to effective date.
6. Confirm the contract and effective date
When you are approved you will receive a contract, a fee schedule and an effective date. Do not bill for sessions before that date unless the payer confirms in writing that retroactive billing is allowed.
Medicare for MFTs and mental health counselors
Since January 1, 2024, marriage and family therapists and mental health counselors can enroll in Medicare as providers. Enrollment goes through PECOS, and if you work in a group you will also reassign your benefits to it. CMS publishes the current enrollment requirements on cms.gov.
What to do while you wait
- Keep seeing private-pay clients and offer a superbill they can submit for out-of-network reimbursement.
- Keep your CAQH profile and malpractice coverage current.
- Verify each new client’s behavioral health benefits instead of assuming they are covered.
If you’d like a hand, read how our insurance credentialing service works, or see our therapy billing services for what happens after you are in network.
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