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Insurance, Medi-cal, Medicare

LPCCs are reimbursed by most managed care organizations and health plans in California.

CALPCC sponsored a bill in the 2011 legislative session which amended the Insurance Code to include LPCCs. California LPCCs were added as providers effective July 1, 2012. 

LPCCs are medi-cal providers

LPCCs were added as qualified providers of Medi-Cal specialty mental health services on February 21, 2014. The Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services has advised the California Department of Health Care Services (DHCS) that it has approved the California State Plan Amendment (SPA) to add LPCCs and PCI Interns as providers for Medi-Cal Rehabilitative Mental Health and Targeted Case Management services. The SPA was signed on December 18, 2012, and the effective date is July 1, 2012. Those who would like the details can read the SPA here.

The announcement was made at the California Mental Health Directors Association's Medi-Cal Policy Committee meeting on January 16, 2013. County agencies and agencies that contract with the counties can hire LPCCs and PCCIs. LPCCs and PCCIs can practice within their scope of practice under state law and will have the same requirements and privileges as LMFTs, MFTIs LCSWs and ASWs.

Medi-Cal reimbursement will only be available to private practitioners if they have a contract with their county mental health department, as is true for LCSWs, LMFTs and psychologists.

LPCC are Medicare providers starting 2024

The Mental Health Access Improvement Act (H.R. 432), which recognizes mental health counselors and marriage and family therapists as approved Medicare Part B providers, was signed into law on December 29, 2022 as part of the Consolidated Appropriations Act, 2023 (Public Law No. 117-328). The law will go into effect on January 1, 2024

This law is a significant step forward in expanding access to mental health care for Medicare beneficiaries. Previously, only psychologists and psychiatrists were approved Medicare Part B providers. This law will allow millions of Medicare beneficiaries to see mental health counselors and marriaged and family therapists for covered services.

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