Psychologist credentialing in Texas: licensed psychologists, PLPs and LPAs

• LPC
• LCSW
• LMFT
• Psychologist
• LCDC
• Psychiatric NP

At a glance, by license level

The Texas State Board of Examiners of Psychologists, part of the Behavioral Health Executive Council, issues each of these. Plans look you up there.

What plans verify about a psychologist

• The license and its level, on BHEC's verification search: licensed psychologist, PLP or LPA, the number, expiration and any board orders. A recently upgraded PLP must replace the provisional number everywhere (NPPES, CAQH, every application) before filing.
• The doctorate. Medicare's definition turns on a doctoral degree in psychology, and commercial plans verify it. Keep the diploma ready and know where your program's records are held.
• Internship and postdoctoral history on your CV, with month and year, and any gap of more than a few months explained.
• Board certification, if you hold one: optional for most plans, but list it.
• Malpractice declarations and claims history, and a clean check on the OIG exclusion list.

Taxonomy: NUCC lists psychologists under 103T00000X, with specialty codes beneath it. Pick the one that matches how you'll be credentialed and mark it primary in NPPES; a testing practice and a therapy practice may choose differently, and a plan that credentialed you under one may reject claims carrying another. More in NPI Type 1 vs Type 2. The full packet is on our credentialing documents checklist.

Medicare: the clinical psychologist rule

Medicare enrolls a "clinical psychologist" who holds a doctoral degree in psychology and is licensed or certified, on the basis of that doctorate, at the independent practice level of psychology in the state where they practice (42 CFR 410.71(d)). Covered services are those within your state license that Medicare would cover if a physician provided them. In practice:

• Licensed psychologists enroll in PECOS on the CMS-855I, with no application fee. A Medicare contractor may ask for your license or proof of education while it reviews (First Coast Service Options, clinical psychologist enrollment).
• LPAs hold a master's-level license, so they don't meet the doctoral requirement even with independent practice authorization.
• PLPs aren't licensed at the independent practice level until the full license is issued.
• The rate: clinical psychologists are paid from the physician fee schedule. Social workers, MFTs and mental health counselors receive 75% of the clinical psychologist amount for the same service (42 CFR 414.53), which is why a psychologist's Medicare rate is the highest of the therapy licenses.
• File before the first Medicare client; Medicare limits billing back to 30 days before the filing date (42 CFR 424.521). If a group bills for you, reassign to it on the same application.

Texas Medicaid

• Licensed psychologists enroll individually through TMHP (and the group, if you bill through one), then with each managed care plan in the area. Texas expects providers who serve people with both Medicare and Medicaid to enroll in Medicare first (1 TAC §352.13).
• Rates by level. HHSC's chief medical director told lawmakers in 2023 that psychologists are paid 100% for psychotherapy; LCSWs, LMFTs and LPCs 70%; and supervised post-doctoral psychology fellows and pre-doctoral psychology interns 50% (Texas Tribune). Check the current TMHP fee schedule for your codes.
• PLPs and LPAs. Texas's Medicaid state plan covers services by a PLP or LPA only when they're within that person's scope and under the direct supervision of a licensed psychologist (Texas state plan amendment TX 13-24). The same document bars a psychologist who's employed or paid by an enrolled provider from billing Medicaid directly when that would duplicate the employer's payment.
• Group joiners: Medicaid managed care plans must offer an expedited process to Medicaid-enrolled psychologists joining an established contracted group (1 TAC §353.423).

PEMS, the managed care plans and revalidation are in our Texas Medicaid credentialing guide.

Delegation: billing for PLPs and new psychologists

Texas has a statute aimed squarely at a credentialing gap. Under Texas Occupations Code §501.351, a licensed psychologist may delegate a psychological test or service that a reasonable and prudent psychologist could delegate to:

• a provisionally licensed psychologist,
• a newly licensed psychologist who isn't yet eligible for managed care panels,
• a person with a temporary license, or
• a person in a formal internship.

The delegating psychologist stays responsible for the work, and for billing purposes, including bills to third-party payers, the test or service is treated as delivered by the delegating psychologist. The person doing the work must tell each patient that a licensed psychologist supervises them. Two cautions from the billing side:

• Your contracts still matter. Each plan's provider manual and your contract decide what it pays for and how the claim is built. Read them, and where they're silent, ask the plan in writing before you bill delegated services under your NPI.
• Medicare and Texas Medicaid have their own rules. Medicare's supervision and "incident to" rules and Medicaid's direct-supervision requirement apply on their own terms. Have your biller confirm the current rules before you rely on delegation for those clients.

For a newly licensed psychologist, the practical plan is: file every application the week the full license posts, and bill delegated services under a supervising psychologist only where the statute and the plan both allow it. How supervision is documented is in supervising associates and interns in Texas.

LPAs with independent practice

Texas lets an LPA apply for independent practice after at least 3,000 hours of post-graduate supervised experience, gained over 24 to 48 consecutive months in no more than three placements (22 TAC §463.8; BHEC's LPA licensing page). Independent practice authorization changes what the board allows, not what a payer must accept. Before applying to a commercial plan, ask: does it have a provider type for an LPA, does it require independent practice authorization, and which codes will it pay an LPA for. Medicare remains closed to LPAs because of the doctoral requirement.

PSYPACT and telepsychology

Texas joined the Psychology Interjurisdictional Compact through HB 1501 in 2019 (BHEC's PSYPACT page). PSYPACT can authorize telepsychology to clients in other member states; it doesn't put you in any insurance network there. A plan in another state credentials you under its own rules, and Medicare enrollment is tied to where you practice. If you'll see out-of-state clients under PSYPACT, ask each plan whether it will credential you for members located in that state, or plan those clients as self-pay.

Testing practices: what to ask each plan

Psychological and neuropsychological testing is where psychologist claims most often stall. Before you sign a contract, ask each plan:

The prior authorization guide covers how to request and track the hours once you're in.

The step list

1. Confirm the license level on BHEC and match your legal name to your IRS letter and bank account. Day 1
2. NPPES: the psychologist taxonomy that fits your practice as primary; a Type 2 NPI if a PLLC or group bills. Days 1–5
3. Packet and CAQH: doctorate, internship and postdoc dates, license, malpractice, CV; attest and authorize every plan. Weeks 1–2
4. Medicare in PECOS (licensed psychologists), with reassignment to the group. Week 2; we budget about 60 days
5. Commercial applications, after asking the testing questions above. Week 2; 60–120 days each
6. TMHP, then each Medicaid managed care plan. After the Medicare number; 60–120 days per plan
7. Contracts: rates for 90791, psychotherapy and testing codes; prior authorization rules; timely filing; termination. As each arrives
8. Effective dates and IDs in writing, loaded before the first in-network visit. Delegation set-up (who does what, under whose NPI) written into your policy. Before the first claim

The general process for any license is in how to get credentialed with insurance.

What it costs

No government fee applies to an individual psychologist's NPI, CAQH profile or Medicare enrollment. Through our credentialing service: CAQH $250 per clinician, each plan $175 per plan, Medicare $350 per clinician, Texas Medicaid $350 per clinician. A licensed psychologist taking CAQH, Medicare, Texas Medicaid and five commercial plans would pay $1,825. Try your own set in the credentialing cost calculator.

Opening a practice? Solo Practice Launch: Complete ($3,450) includes six plans with Medicare and billing set-up. Building a testing or therapy group with PLPs and postdocs? The Group Practice Launch ($7,500) includes group contracts, each clinician credentialed and linked, and the supervision plan; see also how to start a group practice in Texas.

Questions

More credentialing guides by license: LPC · LCSW · LMFT · LCDC · Psychiatric NP.

Sources

Checked October 24, 2026.

1. Texas Behavioral Health Executive Council. bhec.texas.gov
2. 42 CFR 410.71, clinical psychologist services. law.cornell.edu
3. First Coast Service Options, clinical psychologist (CP) enrollment. medicare.fcso.com
4. 42 CFR 414.53, fee schedule for clinical social worker, MFT and MHC services (75% of the clinical psychologist amount). law.cornell.edu
5. 42 CFR 424.521, retrospective billing. law.cornell.edu
6. Texas Occupations Code chapter 501 (§501.351, delegation and billing). statutes.capitol.texas.gov
7. 22 TAC §463.8, licensed psychological associate. law.cornell.edu; BHEC, how to become an LPA. bhec.texas.gov
8. BHEC, PSYPACT. bhec.texas.gov
9. Texas Medicaid state plan amendment TX 13-24 (psychologist, PLP and LPA services). medicaid.gov
10. Texas Tribune, Texas Medicaid behavioral health rates, April 28, 2023. texastribune.org
11. 1 TAC §352.13 (Medicare before Medicaid) and 1 TAC §353.423 (expedited credentialing). §352.13; §353.423
12. NUCC taxonomy code set. nucc.org; HHS OIG exclusions. oig.hhs.gov

General information, not legal or billing advice. Cima Consulting isn't a law firm or an accounting firm. Payers make their own credentialing decisions; we don't guarantee approvals, rates or dates.

Opening your own practice? Read starting a psychology private practice in Texas for the business, payer and opening steps that go with credentialing.