Requirements for Mental Health Extenders
Provider Administrative Policy
Mental Health Physician
Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts
Mental Health Extenders
Blue Cross of Idaho contracts directly with Idaho licensed physicians (MDs or DOs), psychologists (PhDs), licensed clinical professional counselors (LCPCs), licensed marriage family therapists (LMFTs), and licensed clinical social workers (LCSWs).
Blue Cross of Idaho covers other licensed professionals who provide services extending the treatment started by a contracting physician or psychologist (psychologists are limited to three service extenders). Blue Cross of Idaho only allows MDs, DOs, psychologists LCSWs, LMFTs or LCPCs to sponsor service extenders. LCSWs, LMFTs and LCPCs must hold supervisory credentials in accordance with IDAPA regulations. The supervising physician, psychologist LCSW, LMFT or LCPC's tax identification number and contracting status determines reimbursement for extended services.
Eligible Mental Health Extenders
- Licensed professional counselors (LPCs) whose provision of psychotherapy is supervised in compliance with IDAPA 24.15.01, "Rules of the Idaho Licensing Board of Professional Counselors and Marriage and Family Therapists"
- Licensed masters of social work (LMSW) whose provision of psychotherapy is supervised in compliance with IDAPA 24.14.01, "Rules of the State Board of Social Work Examiners"
- Licensed associate marriage and family therapist (LAMFT)whose provision of psychotherapy is supervised in compliance with IDAPA 24.15.01, "Rules of the Idaho Licensing Board of Professional Counselors and Marriage and Family Therapists"
- Licensed psychologist extender, registered with the Bureau of Occupational Licenses whose provision of services is supervised in compliance with IDAPA 24.12.01, "Rules of the Idaho State Board of Psychologist Examiners"
Eligible mental health extenders must:
Practice within the scope of their professional licensure and in compliance with IDAPA.
Support covered providers in their practice and render separately identifiable services for covered providers.
Have a completed provider information sheet (PIS) on file.
Have a provider number designating him or her as the performing provider.
Be licensed and/or registered within the state where the services occur.
Please note: Blue Cross of Idaho does not credential providers classified as service extenders. Service extenders will not appear in the provider directory or be required to complete a credentialing application.
Please contact your provider relations representative for contract information or a provider information sheet.
|November 2014||Revised||Added note regarding service extenders|
|January 2011||Revised||Supervisory credentials added|
|January 2010||Revised||Behavioral health extender information added|
|November 2009||Revised||Professional requirements added|
|September 2009||Moved||Moved from PAP376 (Ancillary) to PAP900 (Behavioral Health)|
|May 2008||Revised||Language clarification|