Credentialing by state / Texas
Therapist Credentialing in Texas
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
Texas belongs to PSYPACT, which decides how easily LPCs, LCSWs, LMFTs and psychologists in Houston, Dallas, San Antonio and Austin can treat clients across state lines. It does not change payer enrollment: Texas Medicaid, Blue Cross and Blue Shield of Texas and Medicare each credential you on their own, whatever your license route.
| PSYPACT (psychologists) | Effective, since July 1, 2020 |
|---|---|
| Counseling Compact (LPC/LMHC) | Not a member |
| Social Work Compact (LCSW) | Not a member |
| LMFTs | No interstate compact; license in each state |
| Medicare contractor | Novitas Solutions, jurisdiction JH |
| Medicaid | Texas Medicaid, 15 managed-care plans |
| Commercial decision deadline | 90 days (28 Tex. Admin. Code § 11.1402) |
Licensure Compacts in Texas
PSYPACT for psychologists
Texas's PSYPACT law took effect on July 1, 2020. A psychologist whose home state is Texas can apply through ASPPB for the E.Passport, which supports the Authority to Practice Interjurisdictional Telepsychology (APIT), and for the IPC, which supports temporary in-person practice (TAP) in other PSYPACT states. Both depend on holding an unrestricted Texas license, and both are separate from payer enrollment.
Across the border, Arkansas and Oklahoma also participate; Louisiana and New Mexico do not, so telepsychology with clients located there still needs that state's own license.
Counseling Compact for LPCs
Texas has not joined the Counseling Compact, while Arkansas, Louisiana and Oklahoma on its border have. An LPC licensed elsewhere who wants to see clients located in Texas, in person or by telehealth, needs a Texas license, and Texas counselors cannot get privileges in the 40 member jurisdictions.
Social Work Licensure Compact for LCSWs
Texas is not a member of the Social Work Licensure Compact. Even in the 33 member jurisdictions, multistate licenses are not yet available, so for Texas LCSWs the practical rule is unchanged: a license in each state where clients are located.
Compacts Grant a License Route, Not a Network Seat
A compact privilege is permission to practice; it is not enrollment. A Texas therapist who adds clients in another state through a compact still needs that state's Medicaid enrollment, a practice location the plans accept there, and a separate application to each commercial plan or behavioral health network in that state. CAQH (DataSpring) carries the extra license or privilege, but every payer decides on its own timeline.
Medicare for Texas LMFTs and Counselors
Since January 1, 2024, Medicare pays marriage and family therapists and mental health counselors directly, and a Texas LPC qualifies as a mental health counselor when the license and degree meet the federal definition. Enrollment is the CMS-855I in PECOS, reviewed for Texas by Novitas Solutions; payment is 75% of the clinical psychologist amount. LCSWs and psychologists were already eligible, so for Texas practices this is the first time every licensed therapist on staff can be a Medicare provider.
Texas Medicaid and Its Plans
Texas Medicaid enrollment is filed with the Texas Health and Human Services Commission through the TMHP Provider Enrollment and Management System (PEMS). Most members are in managed care, and each plan credentials therapists as its own application once the state enrollment is active. The largest by 2024 enrollment:
- Superior HealthPlan: 950,499 members, owned by Centene
- Wellpoint: 684,884 members, owned by Elevance Health
- Texas Children's Health Plan: 417,218 members
See all 15 plans; confirm with each one whether it credentials behavioral health directly or through a vendor.
Texas Rules for Commercial Plans
Texas law gives commercial plans 90 days to decide, counted from an application for participation, for HMOs (28 Tex. Admin. Code § 11.1402). The Texas Standardized Credentialing Application, required of hospitals, HMOs and PPOs. (Tex. Ins. Code § 1452.052) Expedited credentialing: physicians and certain others joining an established contracted group are paid in-network once their information is submitted, pending approval. (Tex. Ins. Code ch. 1452, subch. C)
Neighboring States
- Arkansas: PSYPACT yes; Counseling Compact live; Social Work Compact enacted
- Louisiana: PSYPACT enacted, later start; Counseling Compact live; Social Work Compact enacted
- New Mexico: PSYPACT no; Counseling Compact no; Social Work Compact unsettled
- Oklahoma: PSYPACT yes; Counseling Compact live; Social Work Compact enacted
The full checklist, the carve-out networks and timelines are in our therapist credentialing guide; Medicare, Medicaid and commercial basics for every clinician type are on credentialing in Texas.
Questions Texas Therapists Ask
Can a Texas LPC see clients in another state by telehealth?
Only with a license from the state where the client is located. Texas is not in the Counseling Compact, so there is no privilege-to-practice route from here.
Is Texas a PSYPACT state?
Yes. Texas's PSYPACT law took effect on July 1, 2020. Texas psychologists can practice telepsychology into other participating states under APIT once ASPPB issues the E.Passport, but each payer still credentials them per state.
How does a Texas therapist join Texas Medicaid?
Enroll with the Texas Health and Human Services Commission through the TMHP Provider Enrollment and Management System (PEMS). Texas Medicaid enrolls 3,842,754 people across 15 managed-care plans (2024), and each plan you want, such as Superior HealthPlan, Wellpoint, Texas Children's Health Plan, credentials you separately once the state enrollment is active.
Can Texas LMFTs and counselors bill Medicare?
Yes, since January 1, 2024. Marriage and family therapists and mental health counselors licensed in Texas enroll on the CMS-855I through PECOS, reviewed by Novitas Solutions, and Medicare pays them 75% of the clinical psychologist amount. They need 2 years or 3,000 hours of post-master's supervised clinical experience.
Answers cover PECS services, prices and process. For legal, tax or clinical questions please consult a professional.
Sources: PSYPACT Commission, participating states map and legislation table; Counseling Compact Commission, member states and news and go-live announcements; Social Work Licensure Compact Commission, member jurisdictions and news and status updates; CMS, Marriage and Family Therapists and Mental Health Counselors; KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024; Texas statute. Compact status as of October 8, 2026; confirm with the Texas licensing board before relying on it.