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Insurance Updates and Resources

An ongoing series of informational entries

Professional Counselors are now recognized by Medicare

January 15, 2023

After more than a decade of working to secure Medicare coverage for counselors’ services, NBCC, the Medicare Mental Health Workforce Coalition, and counselors across the country can celebrate the passing of the omnibus package, which achieved our goal! The package, which includes language from the Mental Health Access Improvement Act (S. 828/H.R. 432) that expands coverage of mental health counselors (MHCs) and marriage and family therapists (MFTs) under Medicare Part B, was signed into law by President Biden on Dec. 29, 2022.

Coverage of MHCs and MFTs under Part B of the Medicare program will begin Jan 1, 2024. Medicare is the largest healthcare program in the country, covering more than 55 million people. It currently recognizes psychiatrists, psychologists, clinical social workers, and psychiatric nurses for outpatient mental health services, and now counselors and MFTs will be added to the list. Because Medicare is the country’s flagship healthcare program, counselor inclusion is key to ensuring parity with other professions.

The Centers for Medicare & Medicaid Services (CMS) will now develop specific rules on how counselors can apply for provider status, receive a Provider ID number, and bill for services. The rules will be developed in 2023 ahead of the Jan 1, 2024, implementation.

Tricare Benefits Cards

January 09, 2022

Finding the elusive DOD Benefits number can be daunting sometimes. Here's where to look at the Common Access Cards and other military IDs. 

BCBS of NC Telehealth Update

January 09, 2022

In response to the recent coronavirus (COVID-19) outbreak, Blue Cross Blue Shield of North Carolina is expanding reimbursement for ALL services delivered through telehealth that meet the criteria outlined below. The expansion supports diagnosis and treatment of COVID-19, as well as minimizes unnecessary exposure to individuals needing medical care for other conditions. Reimbursement for the expanded set of services delivered through telehealth will be in effect during the COVID-19 pandemic effective from March 6, 2020, through March 31, 2022.  We will reevaluate if an additional extension is needed as we approach March 31.

Cigna Telehealth Update

January 02, 2022

Interim billing guidelines for Coronavirus (COVID-19)

Individual providers and outpatient clinics

If you are an individual provider or an outpatient clinic, you may use telehealth for outpatient therapy, applied behavior analysis (ABA),* medication management, and Employee Assistance Program (EAP) services. You may offer telephonic sessions to patients who do not have access to technology to participate in telehealth sessions, as appropriate and in accordance with current legislative guidance. Include the following information on your claim form:


Appropriate Current Procedural Terminology® (CPT®) code in Field 24-D for the service(s) provided

Modifier 95** in Field 24-D to specify telehealth

Place of Service (POS) 02 in Field 24-B 


How to verify your benefits?

December 10, 2021

  1. Call your Insurance company and ask if your plan covers Mental Health or Behavioral Health benefits.
  2. Ask if your plan has a deductible: If so, ask if you have met any amount towards the deductible. Sometimes there is an individual and/or a family deductible.
  3. Ask if you have a co-pay or co-insurance: If so, ask what the co-pay or co-insurance is for therapy sessions.
  4. Ask if you have to have a referral or a prior authorization before you see us (or a therapist).
  5. Ask if there are any limits to how many sessions you can have in a calendar year: If so, how many? Sometimes there is an initial limit but there can be a request for more sessions if they are needed.

What if a therapist is not “In-Network” with your insurance plan?

December 3, 2021

Call your insurance and ask if you have Out of Network benefits (OON)? If you have OON benefits, ask if you need to have a referral or an authorization to use these benefits. You'll also want to verify how much they will reimburse you for your therapy sessions if any. 


Ensure you get the fax number or address to submit for any reimbursements.  If you are utilizing OON benefits for your therapy sessions, you will be expected to pay the full session fee at the time of service. The therapist should provide you with what’s called a  ‘superbill’ to submit to your insurance company for the reimbursement. 

A ‘superbill’ is similar to a detailed receipt that you can send to them. 
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