Mental Health billing for Licensed Professional Counselors and Medicare

by Debbie Gilbert
(Washington, DC Metro area)

I have been billing for mental health for the last 20 years and one of the MOST frustrating parts of my job has been billing for Licensed Professional Counselors (LPC) when Medicare is the Primary and another insurance is secondary.

After all these years with so many "different" responses to the question of how to get a denial from Medicare so that the Secondary will pay. FINALLY, I received a response from BCBS that stated since an LPC is NOT a covered provider for Medicare - I just need to bill Secondary as the Primary (no modifiers, nothing, no selecting if client has another insurance, etc.) and it has worked like a charm. I hope this helps someone who bill mental health.

Response:

Thanks for sharing Debbie! We also have encountered similar frustrations in billing for mental health providers when Medicare is the primary.