Please note: If you do not have a PTAN by January 1, 2024, you will no longer be able to receive payment for our Medicare Advantage members.

Effective January 1, 2024, the Centers for Medicare & Medicaid Services (CMS) will require all licensed professional counselors (LPCs), licensed marriage and family therapists (LMFTs), and licensed mental health counselors (LMHCs) to have an active Provider Transaction Access Number (PTAN) to be considered eligible and remain in-network with our Medicare Advantage plans.

What is a PTAN? 

A Provider Transaction Access Number (PTAN) is a unique identifier assigned to healthcare providers by CMS. It is a key component in the Medicare enrollment process, allowing providers to bill Medicare for their services and to maintain their in-network status with Medicare Advantage plans.

Key dates

• PTAN application period: This began November 1, 2023.
• Implementation date: The new requirement will take effect January 1, 2024.

Why is a PTAN necessary? 

The introduction of PTAN requirements for LPCs, LMFTs, and LMHCs is designed to ensure the highest standards of quality and compliance in Medicare services. This change is part of a broader effort to enhance the integrity and security of the Medicare program. Additionally, having a PTAN is vital to maintaining your status as an in-network provider with our Medicare Advantage plans.

Action required: 

To remain in-network with our Medicare Advantage plans, and to ensure your eligibility for the Medicare program, you should apply for a PTAN as soon as possible, to ensure you have it in place by January 1, 2024. 

For guidance on the PTAN application process, and answers to frequently asked questions, please see Page 5 of the CMS FAQ document. 

Thanks in advance for your help

We know that changes like these can be challenging, and we’re committed to assisting you every step of the way. If you have questions, or need help with the PTAN application process, please reach out to our Provider Service team.