Starting a psychology private practice in Texas

1. Which Texas psychology licenses allow private practice

The Texas State Board of Examiners of Psychologists, part of the Behavioral Health Executive Council (BHEC), licenses psychologists under Texas Occupations Code chapter 501 and the rules in 22 TAC chapters 463 (licensing) and 465 (rules of practice).

License	Own private practice?	What to check
Licensed Psychologist	Yes	Credential with commercial plans, Medicare and Texas Medicaid in your own name; supervise others as the rules allow.
Provisionally Licensed Psychologist	No: under a Licensed Psychologist's supervision	Plan the practice for the day the full license is issued, and build the credentialing packet before it.
Licensed Psychological Associate	Check the current rules	BHEC's rules set when an LPA practices under supervision and when independently. Read the current chapter 463 and 465 text, and ask each plan whether it credentials LPAs, before planning a solo practice.
Licensed Specialist in School Psychology	Check the current rules	The LSSP license is built around school settings; confirm with BHEC what you may offer privately before advertising.

2. Testing codes, worked through

Since 2019, psychological testing is billed in pieces: the psychologist's evaluation work (interpreting results, integrating them with other information, writing the report and giving feedback) is separate from administering and scoring the tests, and administration by a technician has its own codes. In plain words:

Code	What it covers	Unit
90791	Diagnostic interview, often the first visit of an evaluation	Per session
96130 / 96131	Psychological testing evaluation services by the psychologist: interpretation, integration, report, feedback	First hour / each added hour
96132 / 96133	The same for neuropsychological testing evaluation	First hour / each added hour
96136 / 96137	Test administration and scoring by the psychologist, two or more tests	First 30 minutes / each added 30
96138 / 96139	Test administration and scoring by a technician, two or more tests	First 30 minutes / each added 30
96127	Brief standardized screening instrument (a PHQ-9 or GAD-7, for example)	Per instrument

3. Running the assessment side

• Ask each plan before the first evaluation: does testing need prior authorization, how many hours does it usually approve, and which diagnoses or referral questions does it consider medically necessary? Our prior authorization guide covers the request.
• Self-pay evaluations need a good faith estimate that lists each expected code and unit, before services (CMS). A bill at least $400 over the estimate can be disputed, so estimate the report time honestly. More in the cash-pay practice guide.
• Collect a deposit for testing days and state it in the financial policy: a missed four-hour testing block can't be refilled the same morning, and plans don't pay for missed appointments.
• Technicians: if someone other than you administers tests, confirm their role is allowed under the board's supervision rules and each plan's policy before you bill 96138 or 96139.
• Test materials and protocols are copyrighted and have their own release rules. Write a policy for record requests that separates the report from raw test data and protocols, and have your attorney read it.
• Your EHR: Cima EHR for therapists has the therapy, family, crisis, intake and screening codes built in, but the 96130–96139 testing codes aren't in its code list yet. If testing is most of your practice, weigh that honestly.

4. Payers for psychologists

Payer	What to know for a psychologist
Medicare	Psychologists have long been Medicare providers; when Medicare added counselors and MFTs in 2024, it set their rate at 75% of what it pays a clinical psychologist (CMS). Enroll in PECOS, with no application fee for individual clinicians, and look up your testing and therapy codes for your Texas locality in the physician fee schedule search.
Texas Medicaid	Enroll through TMHP, then each managed care plan. Texas requires providers serving people with both Medicare and Medicaid to enroll in Medicare first (1 TAC 352.13), and plans must expedite a Medicaid-enrolled psychologist joining an established contracted group (1 TAC 353.423). Details: Texas Medicaid credentialing.
Commercial plans	Credential psychologists widely. Many route behavioral health, including testing authorizations, through a separate behavioral health company; the carve-out guide shows how to tell.
Schools, courts, employers	Pay for evaluations directly. Agree in writing who the client is, who receives the report, the fee and the deadline.

5. Telepsychology and PSYPACT

• Texas is a PSYPACT state. Texas adopted the Psychology Interjurisdictional Compact through H.B. 1501 in 2019 (BHEC, PSYPACT). A Texas Licensed Psychologist who obtains the Authority to Practice Interjurisdictional Telepsychology (APIT), which starts with the ASPPB E.Passport, can provide telepsychology to clients located in other PSYPACT states, within PSYPACT's rules.
• The client's location decides whose law applies. BHEC's telepsychology guidelines treat a psychologist outside Texas as practicing in Texas when the client is in Texas, and remind Texas licensees that the law of the client's state may also apply (Guidelines for the Practice of Telepsychology).
• Competence: the guidelines point to rule 465.9(d): offer services in new areas or with new techniques, remote testing included, only after appropriate study, training and supervision. Check each test publisher's guidance before administering a test remotely.
• Modifiers, places of service and BAAs: see the telehealth practice guide.

6. Psychology rules that shape the practice

• Records: at least 7 years after services end, or 5 years after the client reaches the age of majority, whichever is longer, unless another law requires more (22 TAC 465.22). See how long to keep records in Texas.
• Taxonomy: 103T00000X (Psychologist), or a more specific psychologist taxonomy, such as clinical (103TC0700X), that matches your training. Use the same one in NPPES and on your plan applications.
• Hiring: adding a PLP, LPA or technician turns a solo practice into a supervised one. Write the supervision plan and check each plan's rules for billing supervised work before the first hire; see how to start a group practice in Texas.
• Referrals: pediatricians, schools and attorneys send evaluations. Never give or take anything of value for a referral (Texas Occupations Code chapter 102).

7. Opening, in order

The business, NPI, CAQH, policy and billing steps are the same for every license; follow how to start a private practice in Texas. What a psychology practice adds: a testing fee schedule by code and unit, a testing consent and a record-release policy for test data, deposit and cancellation terms for testing days, the prior authorization workflow for each plan, and storage for test materials. Malpractice for assessment and forensic work can differ from therapy coverage, so tell your carrier what you'll do.

Need only the billing side? Billing set-up is $1,500. Or book a free 30-minute call.

Questions

Can a psychologist open a private practice in Texas?

Yes. A Licensed Psychologist can own and run a private practice, provide therapy and assessment, and credential with commercial plans, Medicare and Texas Medicaid. Provisionally licensed psychologists practice under supervision.

Can a Licensed Psychological Associate practice independently in Texas?

It depends on the current BHEC rules and the LPA's qualifications. Read the current 22 TAC chapters 463 and 465, ask BHEC if unsure, and check whether each plan credentials LPAs before planning a solo practice.

What CPT codes do psychologists use for testing?

96130 and 96131 for the psychologist's evaluation work (first hour and each added hour), 96136 and 96137 for administration and scoring by the psychologist (first 30 minutes and each added 30), and 96138 and 96139 for administration by a technician. Neuropsychological evaluation uses 96132 and 96133.

Is Texas in PSYPACT?

Yes. Texas adopted PSYPACT through H.B. 1501 in 2019. With the Authority to Practice Interjurisdictional Telepsychology, a Texas psychologist can see clients by telehealth in other PSYPACT states.

Do I need a good faith estimate for a self-pay evaluation?

Yes. Uninsured and self-pay clients get a written good faith estimate of expected charges before services, under the No Surprises Act. List each expected code and unit, and remember a bill $400 or more over the estimate can be disputed.

Sources

• Texas Legislature, Occupations Code chapter 501 (psychologists)
• BHEC, PSYPACT; Guidelines for the Practice of Telepsychology (May 2022)
• 22 TAC §465.22 (psychological records), Cornell LII
• CMS, marriage and family therapists and mental health counselors; physician fee schedule search; No Surprises Act
• 1 TAC §352.13 and 1 TAC §353.423; TMHP
• Texas Legislature, Occupations Code chapter 102