Important Information

Regarding

Health Insurance Reimbursement

Medical Assistance (M.A.) Reimbursement

and

Recognition as Mental Health Professional

November 18, 2005

            There is a great deal of misinformation circulating amongst members of the professional counseling community regarding health insurance reimbursement, MA reimbursement, and Mental Health Professional status with the Department of Human Services (“DHS”).  On a daily basis, the Board receives inquiries from licensees, applicants, and interested parties seeking information on these issues.  Many of these people express anger or frustration with the Board, because they believe the Board is or isn’t doing something which is causing these problems.  In order to clarify things, including the Board’s role, the Board has issued this statement with the hope that it will clear up the confusion and answer the questions and concerns of the professional counseling community.

Health Insurance Reimbursement

            One of the concerns of Licensed Professional Counselors and those interested in licensure is whether they will be credentialed by insurance companies for purposes of reimbursement.  There are rumors circulating that insurance companies are not credentialing professional counselors.  Contrary to these rumors, the Board is aware that some Licensed Professional Counselors have been able to be credentialed by insurance companies.  You are therefore encouraged to contact the health insurance companies directly about credentialing, rather than relying upon the rumors.

            Many people ask the Board why it hasn’t done anything about this issue.  The answer to this question is that the Board is doing everything within its authority to have Licensed Professional Counselors recognized by insurance companies.  As a state agency, the Board is legally required to operate within the scope of its legislative authority.  That includes providing licensure verifications to insurance companies when requested to do so, and providing information to insurance company credentialing departments about the Licensed Professional Counselor credential.  What the Board cannot do is actively lobby insurance companies to credential licensed professional counselors.  That is outside the scope of the Board’s authority.  The responsibility for advocating for reimbursement lies with the professional organizations, counselors seeking to be credentialed, and consumers of counseling services who want counseling services covered by health insurance.

M.A. Provider status and Mental Health Professional Status

            Another area of significant concern is whether licensed professional counselors will be able to be recognized as eligible for MA reimbursement for their services.  Part and parcel of this issue is whether licensed professional counselors will be recognized as Mental Health Professionals under the Comprehensive Adult and Children's Mental Health Acts (Minnesota Statutes, chapter 245).  Being a Mental Health Professional is a requirement in the State of Minnesota in order to treat mental illness.

            When the Board was created, it was anticipated that Licensed Professional Counselors would be able to become Mental Health Professionals under section 245.462, subdivision 18, clause (6), or 245.4871, subdivision 27, clause (6).  These provisions allow so-called “allied professionals” to be considered as Mental Health Professionals if the person has a master's degree from an accredited college or university in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical  services in the treatment of mental illness.  While it would appear that licensed professional counselors would certainly meet the educational requirements, DHS has been reluctant to consider LPCs under this provision because of the requirement for 4,000 hours of supervised practice.  Because the Board only requires 2,000 hours of supervised practice for licensure, it only verifies 2,000 hours and cannot document or certify additional hours beyond that.  DHS requires verification of 4,000 hours in order to qualify under the “allied professionals” provision.

            In an effort to resolve this issue, the Board has proposed to create a second tier of licensure.  This credential would be called the Licensed Professional Clinical Counselor (LPCC), and would require, among other things, completion of 4,000 hours of supervised practice prior to licensure as an LPCC.  To ensure that this would be acceptable to DHS, representatives from the Board and the Minnesota Counseling Association recently met with representatives from DHS.  DHS was very helpful, and provided some additional feedback that it would like as part of the licensure requirements in order to have the LPCC credential specifically listed in Chapter 245 as a Mental Health Professional.  The Board is currently working with DHS to come up with a final proposal acceptable to DHS that the Board can attempt to get passed during the 2006 Legislative Session.  If the proposal passes, the Board anticipates that it will be able to license LPCCs after July 1, 2006.

            The Board also discussed the issue of MA reimbursement with DHS.  DHS advised that it was a two-step process; the first step is for LPCCs to be recognized as Mental Health Professionals.  Once Mental Health Professional status is achieved, then the Board can attempt to obtain MA provider status for the LPCC.  DHS strongly discouraged attempting to do both at the same time.

            The Board hopes that you found the above information useful regarding health insurance reimbursement, MA reimbursement, and recognition as Mental Health Professionals.