Wiki Incident-to billing for Behavioral Health - questions

[ajvanekeren]

Hello,

Our practice is office based medication assisted therapy for substance use disorder. Patients can opt in for counseling services. We have LCSW, LPCs, CADCs, and other license types to practice. We do not have a psychologist or psychiatrist on staff. Most payers will not credential any behavioral health license type lower than a LCSW.

What is the the compliant way to get reimbursed for services rendered by license types we can't get credentialed? Is it possible to bill incident-to? If so, who would qualify as a supervising? Or is this a matter of only allowing lower level counselor types to only see patients they are in network with?

Any insight into billing for behavioral health is appreciated! Trying to make sense of it all.

 

[thomas7331]

In the office setting, 'incident to' only applies when a physician owner of the practice is billing for services performed by their own employees or contract workers. If the practice does not have a physician, then there is no way that you could bill 'incident to'.