Medicare allowing LMFTs, LPCs, and LACs to enroll

The Centers for Medicare & Medicaid Services (CMS) has announced a rule change that now allows marriage and family therapists and mental health counselors — including eligible addiction, alcohol, and drug counselors who meet qualification requirements for mental health counselors — to enroll in Medicare for the first time. Newly eligible practitioners can enroll in Medicare as of November 1, 2023, and can start billing Medicare effective
January 1, 2024. Refer to the CMS announcement for more information.

These providers currently must use modifier HO on claims submitted directly to Medicaid without a Medicare denial. The policy will be changing effective April 1, 2024. The use of the HO modifier will only be allowed after April 1, 2024, in situations where enrolled Medicare providers are supervising unlicensed behavioral health providers and submitting claims as the rendering provider.