1) LMFTs are eligible mental health providers for Minnesota Health Care Programs (MHCPs include Medical Assistance [MA], MinnesotaCare, MN Family Planning Program).
2) LMFTs are NOT eligible mental health providers for Medicare.
“But most FQHC Medicare patients are Dual Eligible (i.e., enrolled in both MA & MC). Therefore FQHCs must first bill CMS as a Medicare “billed to deny.” Once the claim is denied by Medicare, the claims should then be submitted to DHS as a Medicaid service. Medicaid will pay the claim at the Medicaid Fee for Service level. DHS will not pay the FQHC rate on claims such as these.
Important Clarification– Medicare mental health services require a doctorate degree (with the exception of MSW licensed clinical social workers, such as LICSWs and LCSWs). So, when any other mental health professional provider (LMFT, LPCC, etc.) with a master’s degree treats a Medicare enrollee that also has Medicaid coverage, the claim follows the process described above.”
**This clarification applies to all non-Medicare eligible BH providers