CurrentBlue Cross Blue Shield - Rhode IslandPolicy N/A

Payment Policy Behavioral Health Supervisory Protocol for Licensed Clinical Social Workers and Post Doctorate Clinicians

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 Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyPayment Policy Behavioral Health Supervisory Protocol for Licensed Clinical Social Workers and Post Doctorate Clinicians

Policy CodePolicy N/A

Change Typeclarified

Effective DateJan 1, 2022

Next Review DateN/A

Key ActionCredentialed outpatient professional providers must submit a supervisory protocol to Behavioralhealth@bcbsri.org and receive BCBSRI approval prior to LCSW or Post-Doctorate Clinician rendering any reimbursable services.

SourceLink

POLICY UPDATE CHANGES

Policy describes BCBSRI supervisory protocol process allowing LCSWs and Post Doctorate Clinicians to render services under supervision and details submission and documentation requirements.

2Clinician types covered under protocol

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Behavioralhealth@bcbsri.orgRequired submission destination (email)

2Required billing modifiers

Policy summary

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.

Policy metadata

PayerBlue Cross Blue Shield - Rhode Island

Policy titleBehavioral Health Supervisory Protocol for LCSWs and Post-Doctorate Clinicians

Policy numberN/A

Effective date2022-01-01

Last review2021-08-04

Submission emailBehavioralhealth@bcbsri.org

Clinician types coveredLCSW; Post-Doctorate Clinician

Supervisory protocol coverage stance

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:

Supervising clinician credentialing: Supervising clinician is independently licensed and credentialed with BCBSRI
Documentation must be included in submission
Supervisory protocol submission and approval: Credentialed outpatient professional provider submits a supervisory protocol to BCBSRI and receives approval prior to LCSW or Post-Doctorate Clinician rendering services for reimbursement
Protocols must be sent to Behavioralhealth@bcbsri.org; Documentation must be included in submission
Supervisory protocol content - written policy: Supervisory protocol includes a written policy addressing the supervisory protocol utilized at the clinic

Billing modifiers and referenced coding guidance

Billing Modifiers for Services Rendered by Supervised CliniciansModifier

HO	Modifier to indicate services rendered by an LCSW
HP	Modifier to indicate services rendered by a Post Doctorate Clinician

Referenced Coding Guidancemixed

CPT	Behavioral Health Outpatient Professional Services CPT codes referenced in separate payment policy

Billing Rule

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.

HO
HP
Claims submitted by uncredentialed clinicians will not be reimbursed

What providers must do

Prior Authorization

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.

Documentation Required

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.

Documentation that the supervising clinician is credentialed with BCBSRI
A written supervisory policy addressing the supervisory protocol used at the clinic
Documentation that the patient is aware the clinician is not credentialed with BCBSRI

Terms

Definitions

LCSWLicensed Clinical Social Worker

Post Doctorate ClinicianClinician pursuing psychologist license post-doctorate

HO modifierModifier to indicate services rendered by an LCSW

HP modifierModifier to indicate services rendered by a Post Doctorate Clinician

Document changes

2021-08-04last_review

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.

2022-01-01effective_date

2021-08-01

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyPayment Policy Behavioral Health Supervisory Protocol for Licensed Clinical Social Workers and Post Doctorate Clinicians

Policy CodePolicy N/A

Change Typeclarified

Effective DateJan 1, 2022

Next Review DateN/A

SourceLink

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