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LMFTs and LMHCs can serve Medicare Advantage members Jan. 1, 2024

To help increase Medicare beneficiaries’ access to mental health providers, marriage and family therapists (MFTs) and mental health counselors (MHCs) will be eligible to participate in Medicare Advantage networks beginning Jan. 1, 2024 provided they have not opted out and do not appear on the CMS excluded or precluded provider lists.

MFTs and MHCs will be able to bill for covered services, and will be eligible to practice in any setting except hospitals and skilled nursing facilities.

MFT qualifications:

The marriage and family therapist category includes licensed mental health therapists (LMFT), marriage and family therapists (MFT), licensed mental health practitioners (LMHP) and independent marriage and family therapists (IMFT).

Marriage and family therapists must:

• Possess a master’s or doctorate degree that qualifies for licensure or certification as a marriage and family therapist pursuant to state law where such individual furnishes the services defined as marriage and family therapist services.
• After obtaining the degree, perform at least two years or 3,000 hours of post-master’s degree clinically supervised experience in marriage and family therapy in an appropriate setting such as a hospital, skilled nursing facility (SNF), private practice or clinic.
• Be licensed or certified as a marriage and family therapist by the state in which services are performed.

MHC qualifications:

The mental health counselor category includes licensed professional counselors (LPC), licensed professional clinical counselors (LPCC), licensed professional counselors mental health (LPCMH), licensed clinical professional counselors (LCPC), licensed mental health counselors (LMHC), licensed independent mental health practitioners (LCMHC) and clinical mental health counselors (CMHC).

Mental health counselors must:

• Possess a master’s or doctorate degree that qualifies for licensure or certification as a mental health counselor, clinical professional counselor, or professional counselor under state law where such individual furnishes the services defined as mental health counselor services.
• After obtaining the degree, perform at least two years or 3,000 hours of post-master’s degree clinically supervised experience in mental health counseling in an appropriate setting such as a hospital, SNF, private practice or clinic.
• Be licensed or certified as a mental health counselor, clinical professional counselor or professional counselor by the state in which services are performed.

If you are a current contracted and credentialed Magellan provider and wish to participate in our Medicare Advantage network, contact the Provider Services Line at 1-800-788-4005 or email ProviderServices@MagellanHealth.com.