Incident to/Supervisory Billing for therapists Explained
Have you ever wondered if there's a way to hire provisionally licensed therapists like LMSWs or MHC-LPs while still accepting insurance in your practice? The answer lies in incident-to/supervisory billing. This billing method allows clients to receive care from a provisionally licensed therapist and utilize their in-network benefits.
Why is this Important?
In many states and with most insurers, only independently licensed providers (such as LCSWs, MHCs, PhDs) are allowed to be credentialed. Hiring provisionally licensed therapists often means they must be out-of-network or cash-only, posing challenges in attracting clients and building a group practice. Fortunately, incident-to billing offers a solution to this dilemma.
How does Incident To/Supervisory Billing Work?
Incident-to billing is permitted by specific insurers and varies by state. In New York, as of the time this blog is published (2023), AETNA and CIGNA are two insurers allowing supervisory billing.
How do you do it?:
An independently licensed clinician must be credentialed with the insurer.
The licensed clinician then supervises the provisionally licensed therapist (e.g., LMSW). Each insurer has different requirements for what the supervisor must do so be sure to check with them.
The provisionally licensed therapist provides care to the client, and when the claim is submitted, it falls under the licensed clinician's NPI.
Different insurers have varied guidelines, so it's crucial to check and obtain written confirmation. Here are detailed requirements and procedures from AETNA and CIGNA
A Couple of Important Reminders
Supervisory billing is not supported through ALMA or Headway; independent credentialing is necessary.
It's advisable to have written agreements with insurers regarding supervisory billing—refer to the provided links for additional assistance.
Stay informed about the latest updates from insurers, as rules and regulations may change. Check their provider sections on their websites for the most recent information.
If you...
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