By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Counseling questions.
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LPCC’s PCCI’s and Medi-Cal – News update from CALPCC
CALPCC the state-wide association for LPCC’s and PCC interns today released a news update confirming that LPCC’s and PCCI’s will be able to bill Medi-Cal here in California. This greatly increases the job opportunities for this new mental health profession.
Professional Clinician Counselors in California will be able to see adults and children. If they wish to see couples or families they will need to have had specific training in family therapy.
This SPA (state plan amendment) was signed in December 2012 with an effective date of July 1, 2012. The result of this SPA is that Professional Clinician Counselors will be able to bill Medi-Cal during the current fiscal year.
For more information please check the CALPCC website. Those of you who plan to practice as Professional Clinician Counselors in California should plan to join CALPCC if you have not already done so.
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I am a PCCI in CA and have been told that Beacon Strategies do not accept PCCs for MediCal billing. I was under the impression that PCCs and PCCIs are accepted by Medi Cal.
Please could you give me more information regarding this matter.
Thank you,
Mary-Anne Wijting
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Currently this situation is very complicated.
At the federal level only LCSW’s and ASW’s can bill Medicaid.
Because of this many hospitals and some child protective services agencies will only hire social workers.
While MFT’s are now licensed in all 50 states and have been licensed in California for over 25 years they still cannot bill federal Medicaid.
California has accepted LPCC’s and PCCI’s to bill Medical.
This does not mean that any insurance company has to accept those billings.
Most counties run their own “insurance” companies and get state Medical funds to pay for services for Medical clients.
At this time about half of those counties will accept LPCC’s and PCCI’s to bill Medical through the county system and or to work for the county.
Just because you get a licenses of any kind does not obligate an insurance company to put you on their panel.
Some insurance companies require you to have been in private practice for 3 or 5 years before accepting your application.
That does not mean they will add you to their panel. They may say they have enough providers in their area.
Further just because you are on a panel does not mean that you will ever get a referral. It just means that insurance company will pay for your services if the client is referred by them for service.
At this time I am not aware of Beacon having any contract to provide Medical services in California. There subsidiary Value options was providing contract services for some patients who have medical but while Value Options will put MFT’s on their EAP panel they are not yet using anyone other than LCSW’s for their medical program. Just because the state will accept PCCI’s billings does not obligate any insurance company to put them on their panels.
Also as a PCCI you can not have your own private practice. Your supervisor must be on the panel. Unless your supervisor has signed an organizational provider agreement with someone you will not be able to bill any insurance under their license.
CALPCC the state wide organization for LPCC’s continues to advocate for the wider use of clinical counselors but getting LPCC’s and PCCI’s on panels has been slow going. The only consolation is that it took MFT’s a while and they are still not being hired in some places. It will take some time to get LPCC’s fully excepted. Hope that explanation helps. If any of you readers has heard anything else let us know.
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