Author Topic: IOP  (Read 1709 times)


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« on: January 30, 2014, 07:46:55 AM »
I am hoping someone can help me.  We are interested in starting an IOP for behavioral services only.  The plan is to have the majority of counseling provided by an LPC w/psychaitry overseeing the program and start with Medicare patients.  We know that LPCs cannot bill in RHC setting so the suggestion was made to bill the services through the hospital, similar to MNT/diabetes mgmt programs.  We are a CAH/Method II billing so everything is on a UB.  All the reference material I have found so far states that Medicare doesn't recognize LPCs as an eligible provider so we weren't sure if these services can be billed.  Can someone point me to some concrete evidence for a yea or nay please?


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« Reply #1 on: January 30, 2014, 11:06:53 AM »
You can find the info on your state's medicare page in regards to LPC's.. Last year there was proposed legislation introduced but we know how long it can be for it to move forward if it moves at all.

As for documentation on other carriers, it's carrier specific and dependent upon the scope of license and the state licensure requirements that determines coverage.   You have to contact the carriers individually.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers