Credentialing by state / Virginia
Therapist Credentialing in Virginia
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
Virginia belongs to all three behavioral health licensure compacts, which decides how easily LPCs, LCSWs, LMFTs and psychologists in Virginia Beach, Richmond, Norfolk and Arlington can treat clients across state lines. It does not change payer enrollment: Virginia Medicaid (Cardinal Care), Anthem Blue Cross and Blue Shield and Medicare each credential you on their own, whatever your license route.
| PSYPACT (psychologists) | Effective, since January 1, 2021 |
|---|---|
| Counseling Compact (LPC/LMHC) | Member, privileges not yet issued |
| Social Work Compact (LCSW) | Member, not yet operational |
| LMFTs | No interstate compact; license in each state |
| Medicare contractor | Palmetto GBA, jurisdiction JM |
| Medicaid | Virginia Medicaid (Cardinal Care), 5 managed-care plans |
| Commercial decision deadline | 60 days (Va. Code Ann. § 38.2-3407.10:1) |
Licensure Compacts in Virginia
PSYPACT for psychologists
Virginia's PSYPACT law took effect on January 1, 2021. A psychologist whose home state is Virginia 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 Virginia license, and both are separate from payer enrollment.
Across the border, Washington, DC, Kentucky, Maryland, North Carolina, Tennessee and West Virginia also participate, so a border practice can reach every adjoining state under APIT once the E.Passport is issued.
Counseling Compact for LPCs
Virginia has passed the Counseling Compact, but as of October 2026 it is not one of the 10 states issuing privileges, so membership does not yet let a counselor practice across the Virginia line. The Commission says members must finish readiness steps, including data sharing and testing, before going live. Next door, Tennessee is already live.
Social Work Licensure Compact for LCSWs
Virginia is one of the 33 jurisdictions listed as members of the Social Work Licensure Compact. The compact will offer a multistate license rather than a per-state privilege, but the Commission's July 2026 update says multistate licenses are not yet available and puts completion of the data system at spring 2027, so Virginia LCSWs still need each state's license today.
Compacts Grant a License Route, Not a Network Seat
A compact privilege is permission to practice; it is not enrollment. A Virginia 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 Virginia LMFTs and Counselors
Since January 1, 2024, Medicare pays marriage and family therapists and mental health counselors directly, and a Virginia 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 Virginia by Palmetto GBA; payment is 75% of the clinical psychologist amount. LCSWs and psychologists were already eligible, so for Virginia practices this is the first time every licensed therapist on staff can be a Medicare provider.
Virginia Medicaid (Cardinal Care) and Its Plans
Virginia Medicaid (Cardinal Care) enrollment is filed with the Virginia Department of Medical Assistance Services through the Provider Services Solution (PRSS) portal. 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:
- Sentara Health Plans: 624,067 members
- Anthem Healthkeepers: 543,748 members, owned by Elevance Health
- Aetna Better Health of Virginia: 271,844 members, owned by CVS Health
See all 5 plans; confirm with each one whether it credentials behavioral health directly or through a vendor.
Virginia Rules for Commercial Plans
Virginia law gives commercial plans 60 days to decide, counted from a completed application, deemed complete 30 days after receipt unless the plan says otherwise (Va. Code Ann. § 38.2-3407.10:1). Once credentialed and contracted, services during the pending period are paid at the in-network rate. (Va. Code Ann. § 38.2-3407.10:1)
Neighboring States
- Washington, DC: PSYPACT yes; Counseling Compact enacted; Social Work Compact no
- Kentucky: PSYPACT yes; Counseling Compact enacted; Social Work Compact enacted
- Maryland: PSYPACT yes; Counseling Compact enacted; Social Work Compact enacted
- North Carolina: PSYPACT yes; Counseling Compact enacted; Social Work Compact enacted
- Tennessee: PSYPACT yes; Counseling Compact live; Social Work Compact enacted
- West Virginia: PSYPACT yes; Counseling Compact enacted; 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 Virginia.
Questions Virginia Therapists Ask
Can a Virginia LPC see clients in another state by telehealth?
Not through the compact yet. Virginia has passed the Counseling Compact but is not issuing privileges as of October 2026, so a license in the client's state is still required. Either way, each payer in that state needs its own enrollment.
Is Virginia a PSYPACT state?
Yes. Virginia's PSYPACT law took effect on January 1, 2021. Virginia 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 Virginia therapist join Virginia Medicaid (Cardinal Care)?
Enroll with the Virginia Department of Medical Assistance Services through the Provider Services Solution (PRSS) portal. Virginia Medicaid (Cardinal Care) enrolls 1,810,041 people across 5 managed-care plans (2024), and each plan you want, such as Sentara Health Plans, Anthem Healthkeepers, Aetna Better Health of Virginia, credentials you separately once the state enrollment is active.
Can Virginia LMFTs and counselors bill Medicare?
Yes, since January 1, 2024. Marriage and family therapists and mental health counselors licensed in Virginia enroll on the CMS-855I through PECOS, reviewed by Palmetto GBA, 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; Virginia statute. Compact status as of October 8, 2026; confirm with the Virginia licensing board before relying on it.