In a groundbreaking move, the landscape of mental health care and substance use disorder (SUD) treatment in the United States is undergoing a significant transformation. The shift began with the proposed 2024 Medicare Physician Fee Schedule, a document that outlined sweeping changes aimed at enhancing mental health and substance use services for millions of Americans.
First on the agenda was the proposal to allow licensed marriage and family therapists (LMFTs) and licensed professional counselors (LPCs), to enroll in Medicare and bill for their services. This pivotal change is designed to break down barriers and make mental health and substance use disorder care more accessible to those in need.
Shortly after the proposed Medicare Physician Fee Schedule was unveiled, the Centers for Medicare & Medicaid Services (CMS) released its 2024 proposed rule on Medicare payment rates for hospital outpatient and ambulatory surgical center (ASC) services. In a move that signaled a profound commitment to addressing mental health, CMS announced its intention to expand coverage of intensive outpatient services – an intermediate level of behavioral health care. This expansion marked a critical step forward in providing comprehensive care for individuals dealing with mental health conditions.
Against this backdrop of change, the Mental Health Access Improvement Act in December 2022 emerged as a turning point in mental health care legislation. Passed in December 2022, this act opened the doors wider, allowing Licensed Professional Counselors (LPCs) and Licensed Marriage and Family Therapists (LMFTs) to step into the realm of Medicare providers.
Previously, only Licensed Clinical Social Workers (LCSWs) were able to provide this service or professionals like LPCs and LMFTs were required to have constant, direct physical supervision from physicians or non-physician practitioners to provide services and receive Medicare reimbursement. However, starting from January 1, 2024, LPCs and LMFTs can independently submit claims to Medicare Part B for their services, securing reimbursement based on the approved Medicare rates without the need for direct supervision by other practitioners.
The impact of these developments reverberates across the mental health care landscape:
In this transformative era of behavioral health care, embracing change is essential. The Mental Health Access Improvement Act, coupled with CMS's initiatives, signals a new chapter in mental health care and SUD treatment accessibility and quality. Aspiring LPCs and LMFTs can now take concrete steps toward becoming Medicare providers, marking a significant leap toward a healthier nation. Visit the Become a Medicare Provider or Supplier webpage on the Centers for Medicare & Medicaid Services (CMS) website, which provides you with tentative information on how to become a Medicare provider. Begin by obtaining an NPI number to help you kickstart the process.
Need assistance with this process? By partnering with organizations like Ascension Recovery Services, you can streamline the process of hiring staff and ensure smooth insurance credentialing. This collaborative approach amplifies the impact of these legislative changes, creating a seamless pathway for mental health professionals to contribute meaningfully to the well-being of individuals and communities. As the behavioral health care landscape evolves, these changes emphasize a simple truth: mental health and substance use disorder treatment is not just an aspect of health care – it is health care.
Contact us today to get started at www.ascensionrs.com.