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PAP900

Requirements for Mental Health Extenders


Provider Administrative Policy

Section
Behavioral Health
Policy Date
February 2008
Status/Date
Revised/January 2010
Provider Type(s)
Mental Health   Physician  

Disclaimer

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.

Policy

Requirements for Mental Health Extenders

Mental Health Extenders

Blue Cross of Idaho contracts directly with Idaho licensed physicians (MDs or DOs), psychologists (PhDs), licensed clinical professional counselor (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 LCSW, LMFT or LCPC's to sponsor service extenders. LCSW, LMFT and LCPC's 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:

  1. Practice within the scope of their professional licensure and in compliance with IDAPA.
  2. Support covered providers in their practice and render separately identifiable services for covered providers. 
  3. Have a completed provider information sheet (PIS) on file. 
  4. Have a provider number designating him or her as the performing provider. 
  5. Be licensed and/or registered within the state where the services occur.  

Please contact your provider relations representative for contract information or a provider information sheet.


Policy History

Date Action Reason
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

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