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LCSW/Medicaid in NYS

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Christy:
I bill for a LCSW in NY. She is now a Medicaid provider. It is my understanding that an LCSW cannot bill straight Medicaid? What about when Medicaid is 2ndry to Medicare?

 
And if she cannot receive any payments from Medicaid, do we still have to fill out the EFT and E-remittance forms for them?  The reps at Medicaid are no help!!

Please help!
thanks :)

Merry:
Definitely a Linda question. I am sure that she will see it tomorrow. She is in NY and knows mental health backwards and forwards.

Michele:
They can only be reimbursed for patients who are QMBs (Qualified Medicaid Beneficiaries).  QMBs are persons who receive SSD because of age or long-term disability.  If she has patients who are QMBs or plans on seeing them then she needs to complete the EFT & other required paperwork.

PMRNC:
LCSW's are covered, and you can bill Medicaid. They do have some restrictions though I believe.. I don't think they can see patients not qualified under 21. I have not had a NY State Medicaid in a long time. Reimbursement is HORRIBLE on mental health claims

https://www.emedny.org/

Michele:
Actually they've revamped the system quite a bit.  They don't pay LCSW's unless the patient is QMB which is not a lot.  But the overall reimbursement for MH has gone up and it's really not that bad anymore.  It did used to be awful.  We bill NYS Medicaid currently for several LCSW's and they don't get reimbursed for straight Medicaid patients.  But the Medicaid HMO's do pay them and their reimbursement isn't bad either.

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