Behavioral Health Supervisory Protocol for Licensed Clinical Social Workers, Postdoctoral Clinicians, Mental Health Counselor Associates, and Marriage and Family Therapist Associates
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Defines BCBSRI's supervisory protocol requirements allowing LCSWs, postdoctoral clinicians, MHC-As, MFT-As, and PAs to render outpatient behavioral health services under specified independently-licensed supervisors and how providers must submit supervisory documentation for reimbursement.
No material clinical or coverage changes in this revision.
Supervised Services Coverage Criteria
Supervised services coverage criteria
Covered when ALL of the following administrative and supervisory requirements are met:
Submit supervisory protocols to Behavioralhealth@bcbsri.org; contact BH Utilization Management at 1-800-274-2958 for more information.
ALL of the following
- a.: Documentation that the supervising clinician is credentialed with BCBSRI.
- b.: A written clinic policy describing the supervisory protocol utilized at the clinic.
- c.: The process by which the supervising BCBSRI-credentialed provider reviews the patient's overall treatment documentation (assessment, treatment plan, and any diagnosis changes).
- d.: A clear process for informing the patient that a clinician who is not credentialed with BCBSRI is providing their care and documentation of the patient's awareness.
- e.: A process supporting regular supervisor–supervisee meetings in accordance with Rhode Island Department of Health guidelines.
- f.: The supervising clinician's Tax ID and National Provider Identifier (NPI).
Use modifiers HO (LCSW/MHC-A/MFT-A), HP (Postdoctoral clinician), or HN (Physician Assistant) as applicable.
Claim Modifiers and Submission Requirements
| HO | Modifier indicating services rendered by an LCSW, MHC-A, or MFT-A |
| HP | Modifier indicating services rendered by a Postdoctoral clinician |
| HN | Modifier indicating services rendered by a Physician Assistant |
Supervisory Protocol Submission Requirement
Submit supervisory protocol and obtain BCBSRI approval before supervised services
Professional outpatient providers credentialed with BCBSRI must submit a supervisory protocol and receive approval from BCBSRI before an LCSW, Postdoctoral clinician, MHC-A, MFT-A, or Physician Assistant may render services for reimbursement. Send the supervisory protocol and required documentation to Behavioralhealth@bcbsri.org and include a cover sheet. Required documentation must demonstrate the supervising clinician is credentialed with BCBSRI; include the supervising clinician's Tax ID and NPI; the clinic's written supervisory policy; the process for supervisory review of patient treatment documentation (assessment, treatment plan, and diagnosis changes); the process for informing and documenting patient awareness that a non‑credentialed clinician provides care; and a process supporting regular supervisor–supervisee meetings per Rhode Island Department of Health guidelines. For questions, contact BCBSRI Behavioral Health Utilization Management at 1-800-274-2958.
- Submit supervisory protocol and receive BCBSRI approval before supervised clinicians render reimbursable services.
- Email protocol and cover sheet with required documentation to Behavioralhealth@bcbsri.org.
- Include supervising clinician credentialing evidence, Tax ID, and NPI.
- Attach clinic's written supervisory policy and supervisory review process for assessment, treatment plan, and diagnosis changes.
- Document patient notification and acknowledgement that a non‑credentialed clinician is providing services.
- Describe process for regular supervisor–supervisee meetings consistent with RI Dept of Health.
- Contact BCBSRI Behavioral Health Utilization Management at 1-800-274-2958 for more information.
Key Roles and Clinician Types
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