NYMHCA is often contacted by agencies that have never hired a mental health counselor before. Here are some of the questions we are asked and the answers. If any of the answers do not provide enough information, please contact us.
Q. Can an agency bill Medicaid for the services of a mental health counselor?
A. Yes...if it's a state funded agency. There have been no problems with billing Medicaid for the services of mental health counselors around the state.
NYS Office of Mental Health Clinic FAQ’s - 2/12
Scroll through the document to question #143:
#143. Is there any consideration for how to bill for services provided licensed mental health counselors (LMHC)?
Medicaid reimburses for clinic services provided by licensed mental health counselors in the same manner as it reimburses for services provided by other licensed mental health practitioners.
Q. Can an agency bill for the services of a student intern?
Students in approved graduate programs leading to licensure can be Medicaid reimbursable using the OMH MMIS non-licensed practitioner ID: 02249154. Private insurers are not required to reimburse for services provided by students.
Q. Can an agency bill for the services of a mental health counselor with a limited permit?
A. Yes they can. The clinical supervisor has to co-sign the forms with the LP holder. It's best to check with the insurance company before submitting the forms.
Q. Who can supervise a mental health counselor with a limited permit?
A. All fully licensed mental health professionals can supervise mental health counseling students and those with limited permits except for LMSW's, LCAT's, LMFT's and LP's.
Q. How many client contact hours does a licensure applicant need to fulfill their 3,000 hours of experience?
A. A mental health counselor needs to have at least 1500 client contact hours doing psychotherapy (out of the required 3,000 total hours) in order to fulfill their licensure requirements. In addition mental health counselors can count time used for phone calls to and from clients, record keeping, supervision, professional development and any other activities related to their work with clients. Internship hours do NOT count toward the 3,000 hours.
Q. Which private insurers accept mental health counselors?
A. Almost all of the major insurance companies doing business in New York, and dozens of the smaller companies already accept LMHC's. The current exceptions are BC/BS companies Excellus and BC/BS of Western NY, Independent Health and Univera. However, if an agency has a contract with a private insurer that does not accept mental health counselors, the mental health counselors on staff are reimbursable.
Q. Can an agency bill Medicare for the services of a mental health counselor?
A. The answer to this is not clear due to the complexity of the Medicare programs and regulations. It would depend on the program and the services being billed for. LMHC's are not yet considered Medicare providers under most circumstances. The inclusion of clinical counselors in Medicare is an issue being worked on at the national level for many years. Currently there are 3 bills in Congress that would add licensed mental health counselors to the list of providers under Medicare.
Q. Are mental health counselors considered QHP's in NYS agencies?
A. Yes! Mental health counselors are considered valuable members of the assessment and treatment teams of state agencies. For example, go to the NYS Office of Mental Health website (OMH.NY.gov) and view the staffing info in the Statewide Comprehensive Plan.
Q. Are mental health counselors authorized to diagnose?
A. This has been a matter of interpretation of our scope of practice and there has been much confusion around this issue. In June of 2012, the NY State Education Department issued a report that discussed the need for clarification of the scopes of practice of all Article 163 professions (mental health counselors are one of those professions) in regard to diagnosis. NYMHCA was pleased to read the report which supports current legislation in the NYS Legislature, calling for diagnosis language to be included in our licensure law. For more information, contact us.
Q. Can mental health counselors with limited permits apply for NPI numbers?
A. Yes. A healthcare provider does not necessarily need a state license to apply for and receive the NPI.
Q. What do employers need to know about the limited permits issued to mental health counselors?
The limited permit is a limited license that is issued until the required experiential hours are completed. The clock starts on the licensure applicant's 3,000 hours only when the limited permit has been issued! It is often posted online before the applicant receives it in the mail. In order to expedite the limited permit approval process, an employer can write a letter that could accompany the permit application. The letter can state that the counselor is in danger of losing the job unless the permit is issued as soon as soon as possible.
**If a counselor does not complete the 3,000 hours with both the 2-year limited permit and the 2, 1-year extensions (total: 4 years), there are no other options available to them. They can never be licensed as a mental health counselor in New York. A letter from the counselor and their supervisor asking that the clock be stopped on the permit, must be sent immediately to the Office of Professions if the counselor realizes that the hours cannot be completed within the 4 year period. Once the applicant finds additional hours or an additional job to complete the hours, they can request that the clock on their permit be resumed.
Q. What can an agency do if there is no clinical supervisor for a mental health counselor that would be acceptable to the State Education Department?
The supervisors of mental health counselors need to be licensed as mental health professionals in the State of New York. They are: physicians; physician's assistants; psychologists; nurse practitioners, and LCSW's). In the event that the agency does not have an on-site supervisor that qualifies, an off-site supervisor is also acceptable to the State Education Department. The off-site supervisor would have to be paid by the agency and not the counselor. The off-site supervisor would also need access to clients and client records as part of their supervisory responsibility and to comply with HIPAA regulations.
Do you have a question that was not answered here? Please contact us.