Author Topic: Billing a LMHC service to Medicare?  (Read 543 times)


  • Sr. Member
  • ****
  • Posts: 295
Billing a LMHC service to Medicare?
« on: June 26, 2017, 11:58:24 AM »
I bill for a LMHC who has a potential patient. Primary is Medicare and 2ndry is BCBS (employer plan, not a supplement) The provider is in network for BCBS and is not in network with Medicare, as Medicare does not cover / credential LMHCs.

If I submitted a paper claim to NGS Medicare, would they actually issue a denial to pass on to BCBS?  I know in the case of Licensed Acupuncturists, Medicare just ignores the claim and will not respond.

So, I am wondering if a LMHC in NY could actually submit to Medicare and receive a proper denial EOMB?

anyone know?


  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4923
    • Solutions Medical Billing
Re: Billing a LMHC service to Medicare?
« Reply #1 on: June 26, 2017, 04:45:18 PM »
Actually you cannot bill Medicare if you are not a Medicare provider, even just to get a denial.  You can contact BC to see if they will consider the claim based on the fact that Medicare does not credential LMHCs.  Some insurance carriers do allow claims if they know that Medicare will not process (do to the fact that they do not credential LMHCs).
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF