Medicare Reimbursement

Passing legislation that allows licensed professional counselors to be reimbursed by Medicare is one of the top priorities for the Government Affairs team.  This legislation has passed the House once and the Senate once in different years.  We are working to get it over the finish line.  Please read about the issue and then go to the Take Action page to contact your representatives in Washington.

Medicare is the nation's largest health insurance program, covering over 43 million older Americans (65 or older), and approximately 10 million Americans with disabilities. The program was established in 1965. Medicare has covered psychiatrists, psychologists and clinical social workers since 1989, but does not cover Licensed Professional Counselors (LPC’s).

There are more than 140,000 licensed professional counselors across the country ready to provide needed treatment, especially in rural areas where they are often the only mental health professional available. LPCs are not able to be reimbursed by Medicare, despite the fact they have education, training, and practice rights equivalent to or greater than existing covered providers. LPCs are licensed for independent practice in all 50 states, and are covered by private sector health plans.

Bipartisan legislation introduced in the House and Senate would improve access to mental health services and permit Licensed Professional Counselors (LPC’s) to be reimbursed by Medicare. In the Senate, the Mental Health Access Improvement Act of 2019, S. 286 was introduced by Senator John Barrasso (R-WY) and Debbie Stabenow (D-MI). In the House of Representatives, the Mental Health Access Improvement Act, H.R. 945 was introduced by Representative John Katko (R-NY) and Mike Thompson (D-CA).

With the passage of this legislation, Medicare beneficiaries nationwide will have access to much needed mental health treatment by licensed professional counselors.

Medicare Reimbursement One Page Handout

Medicare Reimbursement Handout with Coverage Map

Milliman Report on Cost Savings from Integrating Behavioral and Medical Healthcare

 

 

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