The Great Texas Therapy Billing Tango: Can LPCs Finally Bust a Move with Medicare?
Howdy, partners! Ever felt like navigating the world of insurance is wrangling a herd of particularly stubborn longhorns? If you're a Licensed Professional Counselor (LPC) in the Lone Star State, you might be well acquainted with that feeling, especially when it comes to tangoing with the big kahuna – Medicare.
Hold Your Horses! The Good News is Here
Well, fret no more! As of January 1st, 2024, LPCs in Texas (and across the US, yeehaw!) can finally saddle up and bill Medicare Part B for their mental health services. That's right, folks, it's time to dust off your metaphorical boots and get ready to two-step your way to getting reimbursed by Uncle Sam.
But Hold On Now, There's a Catch (Isn't There Always?)
Now, before you start booking up your schedule with Medicare-eligible clients faster than you can say "howdy doody," there's a slight detour on the dusty trail. Here's the thing: to get that sweet, sweet Medicare reimbursement, you gotta get yourself enrolled first.
Enroll? What in Tarnation Does That Mean?
Think of enrollment as getting yourself a fancy new hat – it lets folks know you're officially part of the Medicare posse. Don't worry, the process ain't as complicated as wrangling a rattlesnake. You'll just need to get yourself a National Provider Identifier (NPI) and sign up through the PECOS system (think of it as the exclusive Medicare dance hall).
March Onward, But Don't Forget Your Partner!
Now, here's where things get a little more "Texas two-step" and less "barn dance." As of March 1st, 2024, things got a tad bit more official. If you're seeing clients who are covered by both Medicare and Medicaid (we call them the "dually eligible" folks), you gotta make sure Medicare gets a shot at paying first. Don't worry, it's not about playing favorites, it's just the way the Medicare-Medicaide tango works.
So, Can I Finally Bill Medicare Now?
Yippee-ki-yay! As long as you've got your fancy new hat (enrollment) and remember the dance order (Medicare first for dually eligible folks), you should be good to go. Now you can mosey on over to your favorite online billing platform and start submitting those claims.
Remember, partners, knowledge is power. For more information on how to enroll or the nitty-gritty details of billing Medicare, check out these resources:
- The American Counseling Association: https://www.counseling.org/advocacy/federal-state-issues/medicare-mental-health-workforce-coalition
- Texas Medicaid & Healthcare Partnership: https://www.tmhp.com/sites/default/files/file-library/resources/provider-manuals/tmppm/pdf-chapters/2023/2023-02-feb/2_Behavioral_Health.pdf
Now get out there and show Medicare what a Texas two-step with an LPC looks like!
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