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.  It 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 psychologists and clinical social workers since 1989, but does not cover Licensed Professional Counselors (LPC’s).

 Many Medicare beneficiaries live in mental health professional shortage areas, and there are more than 140,000 licensed professional counselors across the country ready to provide needed treatment. Medicare beneficiaries don’t enjoy the same access to outpatient mental health professionals as those with private health insurance. Medicare does not reimburse Licensed Professional Counselors (LPCs) for the quality, cost-effective treatment that they provide.

Medicare now covers mental health services when provided by psychiatrists, psychologists, mental health clinical nurse specialists, and clinical social workers. LPCs are not covered, 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.

There are more than 140,000 LPCs nationwide, licensed for independent practice. Licensed Professional Counselors are Master’s-degreed mental health professionals, meeting education, training, experience, examination, and ethical standards on par with those of providers already covered by Medicare. That’s why we need legislation which would establish Medicare coverage of LPCs.

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 Seniors Mental Health Access Improvement Act, S. 1879 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. 3032 was introduced by Representative John Katko (R-NY) and Mike Thompson (D-CA).

With Medicare able to cover counseling provided by LPC’s, Medicare beneficiaries nationwide will have access to much needed treatment.

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