Loading...
Defines BCBSRI requirements for supervisory protocols that allow Licensed Clinical Social Workers (LCSWs) and Post-Doctorate Clinicians pursuing psychologist licensure to render outpatient behavioral health services under a supervising independently licensed behavioral health clinician credentialed with BCBSRI; includes submission, documentation, billing modifier, and credentialing requirements.
Policy describes BCBSRI supervisory protocol process allowing LCSWs and Post Doctorate Clinicians to render services under supervision and details submission and documentation requirements.
Scope: Blue Cross & Blue Shield of Rhode Island (BCBSRI) permits Licensed Clinical Social Workers (LCSWs) and Post-Doctorate Clinicians pursuing psychologist licensure to render outpatient behavioral health services when those clinicians are supervised by an independently licensed behavioral health clinician who is credentialed with BCBSRI and an approved supervisory protocol is on file. Supervision and submission requirements: Credentialed outpatient professional providers must submit a supervisory protocol to Behavioralhealth@bcbsri.org and receive BCBSRI approval prior to the LCSW or Post-Doctorate Clinician rendering services for reimbursement; claims must be submitted by the independently licensed, BCBSRI-credentialed supervising clinician and include the HO modifier for LCSW services or the HP modifier for Post-Doctorate Clinician services. Benefits and coverage may vary by group or contract; see the member's Evidence of Coverage or Subscriber Agreement for applicable benefits, deductibles, and copayments. Effective date: 01/01/2022; Policy last updated/last reviewed: 08/04/2021.
Supervisory Protocol Approval Requirements
BCBSRI will allow LCSWs and Post-Doctorate Clinicians to render outpatient services under supervision when ALL of the following are met:
Documentation must be included in submission
Protocols must be sent to Behavioralhealth@bcbsri.org; Documentation must be included in submission
Documentation must be included in submission
Documentation must be included in submission
Documentation must be included in submission
Documentation must be included in submission
Documentation must be included in submission
Operational billing requirement
| HO | Modifier to indicate services rendered by an LCSW |
| HP | Modifier to indicate services rendered by a Post Doctorate Clinician |
| CPT | Behavioral Health Outpatient Professional Services CPT codes referenced in separate payment policy |
Claims must be submitted by credentialed supervising clinician with modifier
Claims for services rendered by LCSWs or Post-Doctorate Clinicians must be submitted by the independently licensed clinician who is credentialed with BCBSRI and must include the HO or HP modifier as appropriate.
Supervisory protocol approval required
Credentialed outpatient professional providers must submit a supervisory protocol to Behavioralhealth@bcbsri.org and receive BCBSRI approval prior to LCSW or Post-Doctorate Clinician rendering services for reimbursement.
Required supervisory documentation
Required documentation includes evidence the supervising clinician is credentialed with BCBSRI, a written supervisory policy, patient acknowledgement that the clinician is not credentialed with BCBSRI, documentation that the supervisor reviews the patient’s assessment/treatment plan/diagnosis, and records of supervisory meetings conducted regularly per Rhode Island Department of Health guidelines.
Include NPI and billing provider numbers
Supervisory protocol submission must include the supervising clinician’s National Provider Identification (NPI) and two-provider-number billing information.
Admission/Outpatient notification may be required
Notification of admission preauthorization may be required for some behavioral health outpatient professional services.
Policy describes BCBSRI supervisory protocol process allowing LCSWs and Post Doctorate Clinicians to render services under supervision and details submission and documentation requirements. Published in Provider Update August 2021; document header effective date 01/01/2022 and last updated 08/04/2021.
Policy describes BCBSRI supervisory protocol process allowing LCSWs and Post Doctorate Clinicians to render services under supervision and details submission and documentation requirements. Published in Provider Update August 2021; document header effective date 01/01/2022 and last updated 08/04/2021.
Published in Provider Update August 2021. Policy describes BCBSRI supervisory protocol process allowing LCSWs and Post Doctorate Clinicians to render services under supervision and details submission and documentation requirements.