Medicare Legislation

Signed into law by Pres 12/29/29
This was part of the Omnibu federal Spending Legislation
LCPCs and LMFTs included to directy bill for Medecare eligible clients
It is expected to take 12-24 months for the rules and
process
to be developed before credentialing and billing will
begin.

You can find the reimbursement rates here:

https://www.cms.gov/medicare/physician-fee-
schedule/search/overview

Click on Begin Search-Click Accept
To give you an idea, here is the dollar amount at present
for an LCSW in IL:

90791 - $155.76

90837 - $101.92

Medicare billing for LCPCs Incident to

Rule change "Incident To" For many years Medicare Rules Allowed Payment to LCPCs if they Are Employed by a Psychiatrist Under Incident To if the MD is on the premises. A recent rule change occurred under CMS. Proposed Rule for Calendar Year (CY) 2023 (CMS-1770-P) and specifically on the Centers for Medicare & Medicaid Services’ (CMS) proposal to increase flexibilities for Medicare-eligible mental health practitioners to use services provided by LCPCs. ACA supported the rule change to allow Incident To billing when the Staff MD is not on premises. 

https://www.federalregister.gov/documents/2022/07/29/2022-14562/medicare-and-medicaid-programs-cy-2023-payment-policies-under-the-physician-fee-schedule-and-other

ACA made numerous recommendations to CMS in support of the profession. These recommendations contributed to the CMS decision to propose allowable general supervision  under the physician fee schedule. The rule is now final and went into effect in January 2023. This rule will improve Medicare eligible client wait time and increase access to care in certain settings. This was the only action CMS is allowed to take without bill passage.

No Surprises Act

Beginning January 1, 2022, psychologists and other health care providers will be required by law to give uninsured and self-pay patients a good faith estimate of costs for services that they offer, when scheduling care or when the patient requests an estimate.

Enacted Dec 2020

https://www.congress.gov/116/bills/hr133/BILLS-116hr133enr.pdf (starts page 1577)
CMS.gov

 S785

This historic legislation directs the U.S. Office of Personnel Management to create the first ever federal government classification for mental health counselors, referred to as an Occupational Series. The Series will allow counselors to work in federal government agencies under the title of mental health counselor instead of generic Series that apply to many professions. Social workers and psychologists have had their own Occupational Series for decades and it is past time counselors have the same level of recognition. Creation of an Occupational Series for mental health counselors has been a top federal priority for national counseling organizations for many years and is a hard won success.

S. 785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019,