05/14/2024
Reminder
As of January 1, 2024, Medicare recognized licensed professional counselors and licensed marriage and family therapists as provider types that can bill Medicare Part B and receive reimbursement for approved services.
On March 1, 2024, Texas Medicaid LMFT and LPC providers must enroll in Medicare or obtain a pediatric practice exemption. An exemption can be indicated in the Program Specific question within the Texas Medicaid and Healthcare Partnership and Provider Enrollment and Management System and the National Provider Identifier record.
If a pediatric-based LMFT or LCP is enrolling in Texas Medicaid as part of a Medicare-enrolled group, then the LMFT or LPC must also be individually enrolled in Medicare. For date of service after January 1, 2024, the provider Medicare number is required to be on file with Texas Medicaid. Medicare must be billed first, or Texas Medicaid will deny the claims.
New and Existing Providers with Medicare question can be found under the Program Specifics Questions section of the Program and Service Participation Details page within PEMS or submit a Medicare Waiver Request.
Resources:
- TMHP Notification Issued February 21, 2024: LPC and LMFT Providers Must Enroll in Medicare Effective March 1, 2024
- CMS Provider Enrollment Frequently Asked Questions: Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs)
- CMS MLN Connects® Newsletter: Marriage and Family Therapists & Mental Health Counselors: Enroll in Medicare Now
Questions
Providers, for questions or additional information, please:
- Contact your BCBSTX Medicaid Network Representative at 1-855-212-1615
- Submit via email Texas Medicaid Network Department