Credentialing is the step where new practices quietly fail. Not because it's hard — because it's slow, it's sequential, and almost nobody tells you the order until you've already lost three months to it.
This is the Florida-specific version: who the payers actually are here, which ones you don't apply to directly, and what the timelines really look like.
Payer applications commonly run 90–180 days from submission to an effective date, and you can't submit until your entity, EIN, Type 2 NPI and attested CAQH profile all exist.
Resign first and you're looking at six months with no insurance revenue. Everything below assumes you're doing this while a paycheck is still arriving. If you haven't done the setup yet, work through the practice setup checklist first — steps 1 through 10 are the prerequisites for this page.
First: should you panel at all?
A real question, not a rhetorical one. Panels mean lower net per session and administrative work you either do or pay for. They also mean a referral pipeline you didn't build and a practice that's available to people who couldn't otherwise afford you.
Most sustainable Florida practices land on a deliberate mix — a few good panels plus private pay. The failure mode isn't choosing insurance or choosing private pay. It's applying to everything indiscriminately, then discovering you're contractually obliged to a payer that reimburses badly and sends you clients you can't schedule.
Pick payers on three things: what your local population actually carries, what each one reimburses for your codes, and whether they're open to new behavioral health providers in your county at all. That last one changes constantly and is worth a phone call before you spend a day on an application.
The five phases
Each opens. The line under each heading is the point of it.
1Commercial payers in Florida Florida Blue is the one you can't ignore here. After that it's Aetna, Cigna, UnitedHealthcare, Humana and the Centene/Ambetter family — and which of them matter depends heavily on your county and your caseload.+
Florida Blue (Blue Cross Blue Shield of Florida) has the largest commercial footprint in the state by a wide margin. For most Florida practices it's the first application and the one that changes your caseload most.
After that, the majors operating here: Aetna, Cigna, UnitedHealthcare, Humana, and Ambetter (Centene, which also owns Sunshine Health on the Medicaid side). Marketplace-heavy counties will also see Oscar and Molina.
Before you apply to any of them, ask two questions by phone:
- Are you open to new behavioral health providers in my county? Networks close, and a closed network means your application sits regardless of how good it is.
- What's the contracted rate for 90837 and 90834 for an LMHC in my area? Some payers will tell you before you sign; some won't. The ones that won't are telling you something.
Your county matters more than people expect. The payer mix in Miami-Dade is not the payer mix in Alachua. If you have an existing caseload, look at what they actually carry — that's better data than any list.
2The carve-out that catches almost everyone For several major payers you do not credential with the health plan. You credential with the behavioral health company they contract to manage it. Apply to the wrong entity and you wait months for nothing.+
This is the single most common wasted month in credentialing, and it's invisible until it's happened to you.
Several large payers don't manage behavioral health themselves. They contract it out. So the application you need isn't the one on the health plan's provider page — it's the one belonging to the behavioral health organization behind it. Commonly:
- UnitedHealthcare → behavioral health typically handled through Optum
- Cigna → typically through Evernorth Behavioral Health
- Various plans → Carelon Behavioral Health (formerly Beacon Health Options)
Arrangements change, and they vary by product line and by state. So don't take this list as final — take it as the question to ask. Before every application, call the payer and ask plainly: "Do you manage behavioral health credentialing directly, or is it delegated? Who do I apply to?"
Thirty seconds on the phone against a month of an application sitting in the wrong queue.
3Medicare — new, and most Florida counselors still haven't done it Mental health counselors became eligible to enroll in Medicare on January 1, 2024. If you last looked into this before then, the answer you got was "no" and it is now "yes."+
This is the biggest change to the field's billing landscape in years, and adoption has been slow because a generation of counselors learned "Medicare doesn't cover us" and never revisited it.
CMS began accepting applications from Mental Health Counselors and Marriage and Family Therapists after November 1, 2023, with claims payable for dates of service from January 1, 2024.
To qualify, CMS requires:
- A master's or doctoral degree qualifying you for state licensure
- At least 2 years or 3,000 hours of post-master's clinical supervised experience
- State licensure or certification as a mental health counselor — CMS notes that professionals licensed under a different state title may enroll if they meet the statutory requirements
Here's the useful part for Florida. The Florida path to LMHC already requires supervised experience over a minimum of 100 weeks — just under two years — alongside 1,500 face-to-face hours. If you're a licensed Florida LMHC, you have almost certainly already met the supervised-experience prong. See the Florida supervision requirements for exactly what you accrued.
Why it's worth doing: an aging population, a payer nobody in your area was serving as a counselor two years ago, and a referral source with genuinely unmet demand. Verify your own eligibility against CMS rather than this page — but if you've been assuming the door is closed, it isn't.
4Florida Medicaid — rebuilt in February 2025 Everything you knew about Florida Medicaid plans is out of date. SMMC 3.0 took effect 1 Feb 2025, the eleven numbered regions became nine lettered ones (A–I), and the plan lineup changed.+
Florida Medicaid runs through the Statewide Medicaid Managed Care program — you don't contract with "Florida Medicaid," you contract with the managed care plans operating in your region.
The current contracts began 1 February 2025 and run through 2030. The previous eleven numbered regions were replaced by nine lettered regions, A through I.
Comprehensive plans operating statewide:
- Humana Healthy Horizons in Florida
- Sunshine Health
- Simply Healthcare Plans
- Florida Community Care
Regional plans: Aetna Better Health of Florida, UnitedHealthcare Community Plan, Molina Healthcare of Florida, and Community Care Plan — each in a subset of regions only.
Do this before anything else: find your region on AHCA's map, then find which plans operate in it. Applying to a plan that doesn't serve your region is wasted effort, and the region boundaries changed in 2025, so an older map will mislead you.
Medicaid reimbursement is lower than commercial. It's also the largest behavioral health payer in the state, and for practices serving lower-income communities it's the difference between being available to that population and not.
5What actually stalls applications Almost every delay is one of six things, and five of them are avoidable by being fussy before you submit rather than apologetic afterwards.+
- An unattested CAQH profile. Complete isn't enough — you have to click attest, and re-attest every 120 days. An unattested profile is invisible.
- Work history gaps. Every month must be accounted for, including school. Unexplained gaps are the number one cause of an application sitting.
- Name mismatches. Your legal name must match character-for-character across Sunbiz, the IRS, NPPES and CAQH. "Smith Counseling LLC" and "Smith Counseling, LLC" are different names to a payer's system.
- Missing Type 2 NPI. You have an individual NPI. Your business needs its own.
- Applying to the wrong entity. See the carve-out above.
- Nobody following up. Applications go quiet, get lost, and sit. Expect to chase every two to three weeks, by phone, with a reference number. This is the part that has nothing to do with competence and everything to do with persistence.
Keep a log of every application: payer, entity applied to, date submitted, reference number, who you spoke to, what they said, and the date you'll chase next. Six months from now you will not remember, and the payer will not remember for you.
This is the part worth handing over
Everything on this page is procedural. It is slow, unforgiving of small errors, and every week of delay is a week you aren't being paid — and none of it makes you better at the work you actually trained for.
Mentality Today does credentialing, payer paneling, billing and claims for solo clinicians and group practices, nationwide. We know which entity to apply to, what stalls a file, and how often to chase. It's the company I co-founded, so weigh that as you like — but if you outsource one thing in building a practice, outsource this.
Talk to Mentality Today →Common questions
How long does credentialing take in Florida?
Commonly 90 to 180 days from a complete submission to an effective date, and it varies by payer. Start while you are still employed — resigning first and applying afterwards typically means around six months with no insurance revenue.
Can mental health counselors bill Medicare now?
Yes. CMS began accepting applications from Mental Health Counselors and Marriage and Family Therapists after 1 November 2023, with claims payable for dates of service from 1 January 2024. Qualification requires a qualifying master's or doctoral degree, at least 2 years or 3,000 hours of post-master's supervised clinical experience, and state licensure.
Do I apply to UnitedHealthcare or to Optum?
Several major payers delegate behavioral health credentialing to a separate organization — UnitedHealthcare commonly through Optum, Cigna through Evernorth, and various plans through Carelon. Arrangements vary by product and change over time, so call the payer and ask who handles behavioral health credentialing before submitting anything.
Which Medicaid plans operate in Florida?
Under SMMC 3.0, effective 1 February 2025, the statewide comprehensive plans are Humana Healthy Horizons, Sunshine Health, Simply Healthcare Plans and Florida Community Care. Aetna Better Health, UnitedHealthcare Community Plan, Molina Healthcare and Community Care Plan operate in specific regions only. Florida moved from eleven numbered regions to nine lettered regions, A through I.
Why is my credentialing application taking so long?
Most delays come from an unattested CAQH profile, unexplained work-history gaps, name mismatches across your Sunbiz, IRS, NPPES and CAQH records, a missing Type 2 organizational NPI, applying to the wrong entity where behavioral health is carved out, or simply nobody following up. Applications go quiet and need chasing every two to three weeks.
Should I join insurance panels at all?
It depends on your market and your goals. Panels mean a lower net per session and administrative overhead, but they act as a referral source and make your practice accessible to people who cannot pay out of pocket. Most sustainable practices use a deliberate mix. The mistake is applying to everything without checking reimbursement and network status first.
This is information, not legal, tax or contracting advice. Payer networks, delegated arrangements, reimbursement and Medicaid plan participation change frequently and vary by county, product line and provider type. Verify everything with the payer directly before you rely on it. Medicare eligibility should be confirmed against CMS; Florida Medicaid regions and plans against AHCA. Verified September 2026.
Sources: CMS — MFT and MHC FAQ · Florida AHCA — Statewide Medicaid Managed Care · CAQH ProView