Wiki Associate Level Mental Health Provider Billing

[Cwebb85]

Are we able to bill for services rendered by associate level mental health providers (LPCAs, CSWs) under the NPI of the fully-licensed supervisor (LPC, LSCW) for commercial payers? I have had a couple of payers tell me yes, but someone at my company is telling me this is absolutely not allowed with any commercial payer. Does anyone know of any commercial payers that do not allow this?

 

[SharonCollachi]

We don't have the levels you are speaking of, so I am unclear if those associate level providers are licensed or not. If they are not licensed, then no, you cannot bill them.

 

[dannimiller]

You can not bill for their services in Texas.

 

[SharonCollachi]

Similar question I just answered: https://www.aapc.com/discuss/threads/incident-to-billing-medicare.174892/?view=date#post-477756

 

[judyglaze@hotmail.com]

Depends on they state. North Carolina a few on the insurances allow this type of billing.

 

[CBUBACK]

Every commercial payer has their own credentialing guidelines as to what licensure types are billable and which are not. You will have to check with each payer as they will not all be the same.

 

[lbouz]

Research the payer policies, commercial payers will be very clear who is eligible to be a covered provider and who is not. These policies will also include a payer's incident to policy. Most commercial payers do not recognize / allow incident to, this is a Medicare concept.