Therapy Practice Compliance & Consulting

Your Practice Deserves Expert Guidance

We help therapy centers navigate compliance requirements, optimize operations, and grow sustainably — from FQHC program requirements to private practice startup and everything in between.

19

HRSA Program Requirements

2026

HIPAA Updates In Effect

100%

Compliance-Focused

50+

States Covered

Our Specialties

Three Pillars of Practice Excellence

Whether you're an FQHC managing federal compliance, a therapist launching a private practice, or a clinic seeking operational improvement — we have you covered.

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FQHC Consulting

Comprehensive consulting for Federally Qualified Health Centers navigating HRSA's 19 program requirements, behavioral health integration, billing optimization, and site visit preparation.

  • HRSA compliance & site visit readiness
  • Behavioral health integration (BHI)
  • UDS reporting & data submission
  • PPS billing optimization
  • Scope of project changes & SAC
  • FTCA deeming application support
  • Sliding fee discount program compliance
  • Board governance training
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Private Practice Consulting

From idea to thriving practice. We guide therapists through every step of launching and managing a compliant, profitable private practice — credentialing, billing, HIPAA, telehealth, and more.

  • Practice startup & formation
  • Insurance credentialing & paneling
  • Medicare & Medicaid enrollment
  • HIPAA compliance setup
  • Telehealth compliance & state licensure
  • EHR selection & implementation
  • Fee schedule optimization
  • Clinical documentation standards
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Business Consulting

Strategic consulting to help therapy practices grow revenue, reduce denials, improve staff retention, and operate more efficiently without sacrificing clinical quality or compliance.

  • Revenue cycle management
  • Denial management & appeals
  • Staff training & development
  • Operational workflow optimization
  • Multi-site expansion planning
  • Payer contract negotiation
  • KPI dashboards & financial analytics
  • Strategic growth planning

Compliance Management

The Compliance Areas That Keep You Up at Night

Therapy practices face an ever-expanding web of federal, state, and payer requirements. We simplify the complex so you can focus on patient care.

HIPAA Privacy & Security

2026 brings stricter enforcement of Security Risk Analyses, updated Notice of Privacy Practices requirements, and new 42 CFR Part 2 alignment for substance use disorder records. We ensure your practice meets every standard.

2026 Deadline

Credentialing & Enrollment

Initial and re-credentialing with commercial payers, Medicare and Medicaid provider enrollment, CAQH profile management, and NPI registry compliance. We handle the paperwork so you see patients.

Core

Clinical Documentation

Treatment plans, progress notes, intake assessments, and discharge summaries that meet payer audit standards and protect your license. We train your clinicians on documentation that gets claims paid.

Core

Billing & Coding

Correct CPT/HCPCS code selection, modifier usage, E/M coding for behavioral health, new 2026 G-codes for interprofessional consults, and digital therapeutics billing. We reduce denials and increase revenue.

Revenue

Telehealth Regulations

Interstate licensure compacts, audio-only billing rules, HIPAA-compliant platforms, informed consent requirements, and the evolving CMS telehealth waivers through 2027. Stay compliant across state lines.

Evolving

Mandated Reporting

States are expanding mandated reporter definitions, narrowing reporting timelines, and requiring new training. We keep your clinicians current on child abuse, elder abuse, and human trafficking reporting obligations.

State-Specific

Supervision & Licensure

State-specific requirements for clinical supervision of pre-licensed therapists — documentation, co-signing, CE requirements, and supervision disclosure forms. We ensure your supervision program is audit-ready.

Operations

OIG & Fraud Prevention

Compliance plans, exclusion screening, anti-kickback awareness, Stark Law basics for therapy referrals, and false claims prevention. Protect your practice from audits and investigations.

Core

FQHC Consulting

Behavioral Health in Federally Qualified Health Centers

FQHCs serve 30+ million patients nationwide and face unique compliance demands. Our FQHC consulting team specializes in behavioral health integration, billing optimization, and HRSA program compliance.

What We Help FQHCs Navigate

HRSA's 19 program requirements touch every aspect of health center operations. For behavioral health specifically, the compliance landscape includes clinical integration, billing complexity, and quality reporting unique to FQHCs.

  • HRSA Operational Site Visits — Preparation, mock reviews, corrective action plan development, and progressive action follow-up
  • Behavioral Health Integration — Primary care/BH co-location models, warm handoffs, screening tools (PHQ-9, GAD-7), and collaborative care (CoCM) implementation
  • PPS Billing Optimization — Encounter rate maximization, same-day visit billing, G-code usage, cost report preparation (CMS-224-14), and rate rebasing
  • UDS Reporting — Clinical quality measures, depression screening & follow-up, SUD metrics, data validation, and Health Center Program data submission
  • FTCA Deeming — Application preparation, credentialing/privileging verification, risk management policies, and claims processing procedures
  • Sliding Fee Discount Program — Schedule development, poverty guideline updates, nominal charge policies, board approval documentation
  • Scope of Project — Form 5A/5B/5C management, SAC submissions, new service/site additions, and column adjustments
  • Board Governance — 51% consumer majority compliance, board training, conflict of interest policies, and bylaws review
  • Telehealth in FQHCs — Medicare reimbursement for audio-visual and audio-only visits, G2025 billing, distant site policies, and the 2027 extension timeline

19

HRSA Program Requirements

$97.53

CY2026 Telehealth Rate (G2025)

92%

Rural FQHCs Offering MH Telehealth

30M+

Patients Served Nationally

42 CFR 2

SUD Record Protections

2028

In-Person MH Visit Requirement

Private Practice Consulting

Launch & Grow Your Therapy Practice

Starting a private practice is exciting — but the compliance, credentialing, and business requirements can be overwhelming. We guide you from concept to thriving practice.

01

Practice Formation & Structure

Entity selection (LLC, PLLC, S-Corp, sole proprietorship), state registration, EIN, NPI acquisition, business banking, and professional liability coverage. We build your foundation right from day one.

02

Insurance Credentialing

CAQH profile creation, commercial payer applications (Aetna, Cigna, UnitedHealthcare, Blue Cross, Optum), Medicare and Medicaid enrollment, and contract negotiation for higher reimbursement rates.

03

HIPAA Compliance Program

Privacy policies, security risk assessments, Notice of Privacy Practices (NPP), Business Associate Agreements (BAAs), breach notification procedures, and staff training protocols aligned with 2026 requirements.

04

EHR & Technology Stack

Selecting HIPAA-compliant EHR platforms (SimplePractice, TherapyNotes, TheraPlatform), practice management systems, secure telehealth platforms, compliant payment processing, and encrypted communications.

05

Telehealth Compliance

State-by-state licensure requirements, PSYPACT and counseling compacts for interstate practice, platform compliance, informed consent templates, and CMS telehealth billing rules through the 2027 extension.

06

Documentation & Billing

Clinical documentation templates, CPT code selection for therapy sessions (90834, 90837, 90847), E/M coding for psychiatric evaluations, modifier usage, superbill creation, and denial management workflows.

07

Clinical Policies & Procedures

Informed consent forms, cancellation and no-show policies, confidentiality agreements, mandated reporting procedures, crisis protocols, and record retention schedules by state.

08

Group Practice Expansion

Adding clinicians, supervision structures for pre-licensed therapists, W-2 vs. 1099 compliance, multi-state licensing, administrative staffing, and culture-building for sustainable group practice growth.

09

Marketing & Client Acquisition

Psychology Today profile optimization, Google Business presence, referral network development, ethical marketing guidelines per your licensing board, and website compliance (ADA, privacy policy).

Business Consulting

Improve Your Practice's Bottom Line

Clinical excellence alone doesn't ensure practice viability. We bring business strategy, operational efficiency, and financial optimization to therapy organizations of every size.

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Revenue Cycle Management

End-to-end claim lifecycle optimization — from eligibility verification and prior authorization through charge capture, claim submission, payment posting, and denial management. We find the revenue leaks and fix them.

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Financial Analytics & KPIs

Build dashboards tracking collections rate, days in A/R, denial percentage, cost per visit, clinician productivity, no-show rates, and payer mix. Data-driven decisions replace guesswork.

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Payer Contract Negotiation

Rate analysis, fee schedule comparison, contract term review, and negotiation strategy for better reimbursement. We benchmark your rates against regional medians and advocate for higher payment.

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Staff Training & Retention

Compliance training programs, onboarding protocols, clinical supervision frameworks, CE tracking, burnout prevention strategies, and compensation benchmarking to reduce turnover.

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Operational Workflow Design

Streamline intake, scheduling, authorization, documentation, billing, and follow-up workflows. Identify bottlenecks, eliminate redundancy, and implement automation where appropriate.

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Multi-Site & Expansion Strategy

Market analysis, location selection, staffing models, regulatory compliance across jurisdictions, centralized vs. distributed operations, and financial modeling for sustainable growth.

⚖️

Compliance Program Development

Build a comprehensive compliance program with written policies, designated compliance officer, regular auditing, corrective action procedures, and staff training that satisfies OIG guidance.

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Mergers & Acquisitions

Due diligence on therapy practice acquisitions, valuation guidance, license and credential transfer, payer contract assignment, and post-acquisition integration planning.

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Technology & EHR Optimization

EHR workflow optimization, reporting configuration, telehealth platform integration, patient portal activation, automated appointment reminders, and secure communications setup.

2026 Compliance Checklist

Is Your Practice Ready for 2026?

Use this checklist as a starting point. If you have gaps, we can help you close them before regulators find them first.

HIPAA & Privacy

  • Updated Notice of Privacy Practices (Feb 2026 deadline)
  • Completed annual Security Risk Analysis (SRA)
  • 42 CFR Part 2 alignment for SUD records
  • Current BAAs with all Business Associates
  • Encryption on all devices storing ePHI
  • Breach notification policy with 24-hour BA requirement
  • Staff HIPAA training documented annually

Credentialing & Enrollment

  • CAQH profile current and attested
  • Medicare PECOS enrollment active
  • Medicaid enrollment current in each state
  • All commercial panels up to date
  • NPI information accurate in NPPES
  • Malpractice insurance current and documented
  • State licensure renewed and verified

Billing & Documentation

  • Current CPT codes for 2026 in billing system
  • New G-codes (G0546–G0551) configured if applicable
  • Treatment plans signed and dated within timeframes
  • Progress notes meet medical necessity standards
  • Denial management workflow in place
  • Timely filing deadlines tracked by payer
  • Superbills/claims include all required data elements

Operations & Governance

  • Compliance plan with designated officer
  • OIG exclusion screening for all staff
  • Mandated reporter training current
  • Supervision documentation (if supervising)
  • Informed consent forms reviewed and updated
  • Telehealth compliance across all practice states
  • Emergency/crisis protocol documented

Compliance & Practice Insights

Regulatory updates, billing tips, practice management strategies, and FQHC compliance alerts.

Get In Touch

Let's Strengthen Your Practice

Whether you're an FQHC preparing for a site visit, a therapist launching a private practice, or a clinic seeking operational improvement — tell us where you are and where you want to be.

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Email

carmencounselingpllc@gmail.com

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Website

litherapycenter.com

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Response Time

Within one business day

Free Compliance Assessment

Schedule a 30-minute consultation and we'll review your current compliance posture, identify gaps, and recommend a prioritized action plan — at no charge.

Request a Consultation

Confidential. We respond within one business day.