Effective January 1, 2024, Marriage and Family Therapists (MFT) and Mental Health Counselors (MHC) can bill Medicare independently for their diagnosis and treatment of mental illness. This policy is a part of the Calendar Year 2024 Physician Fee Schedule Final Rule. 

BACKGROUND 

The Centers for Medicare and Medicaid Services (CMS) have made several changes to Medicare payments to expand access to behavioral health services. Most notable is the change to MFT and MHC enrollment and billing. Previously, MFT and MHC were not eligible to enroll as Medicare providers and could not bill for mental health services provided to Medicare beneficiaries. As a result, Medicare beneficiaries were limited to receiving services from clinical psychologists or doctors. 

MOST RECENT CHANGE TO MENTAL HEALTH BILLING 

According to the CMS website, MFTs and MHC may now enroll as Medicare providers and bill independently for their services. MFTs and MHCs may only bill 75% of what a clinical psychologist is paid under the Medicare Physician Fee Schedule. It is estimated that over 400,000 MFT and MHC can now enroll as Medicare providers.  

HOW TO ENROLL IN MEDICARE AS A MFT OR MHC 

To enroll as a MFT Medicare provider, the professional must: 

1. Possess a master's or doctor's degree which qualifies for licensure or certification as a marriage and family therapist pursuant to State law of the State in which the individual furnishes the services defined as marriage and family therapist services; 
2. Have performed at least 2 years or 3,000 hours of post master’s degree clinical supervised experience in marriage and family therapy in an appropriate setting such as a hospital, SNF, private practice, or clinic; 
3. Be licensed or certified as a marriage and family therapist by the State in which you perform services. 

To enroll as an MHC Medicare provider, the professional must: 

1. Possess a master's or doctor's degree which qualifies for licensure or certification as a mental health counselor, clinical professional counselor, professional counselor under the State law of the State in which the individual furnishes the services defined as mental health counselor services; 
2. Have performed at least 2 years or 3,000 hours of post master’s degree clinical supervised experience in mental health counseling in an appropriate setting such as a hospital, SNF, private practice, or clinic; 
3. Be licensed or certified as a mental health counselor, clinical professional counselor or professional counselor by the State in which you perform services. 



To note, addiction counselors and alcohol and drug counselors who meet all the above MHC criteria may enroll as a Medicare provider and bill for MHC services. 

Links to additional information on enrollment, Medicare-covered services, and instructions on how to bill can be found here.