CurrentOptumPolicy N/A

LMHP provider requirements for billing and supervision (Louisiana)

Governs which clinicians may bill specific behavioral health CPT/HCPCS codes for UnitedHealthcare Community Plan of Louisiana members and supervision/training requirements for non-licensed providers rendering allowable HCPCS-coded services.

Policy Summary

PayerOptum

PolicyLMHP provider requirements for billing and supervision (Louisiana)

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionEnsure CPT-coded services are rendered and billed only by an independently licensed LMHP and update agency roster on ProviderExpress within 10 days of licensed staff changes.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

10 daystimeframe to update agency roster on ProviderExpress

LMHP onlymust render services billed with fee-schedule CPT codes and conduct assessments

1:1required supervision format for non-licensed providers

annualfrequency to maintain non-licensed provider qualifications

Clinician Billing & Supervision Rules

Clinician billing and supervision criteria

Coverage and billing rules based on provider licensure and service code:

CPT-coded services on the Louisiana fee schedule must be rendered and billed by an independently licensed Licensed Mental Health Professional (LMHP); non-licensed providers may not render these services even if supervised.

Assessments (including those establishing a plan of care and determining medical necessity) must be completed, signed, and dated by an LMHP per the Louisiana Medicaid State Plan.

Non-licensed providers may render only specific HCPCS-coded services listed on the Louisiana Department of Health fee schedule (examples include H2017); they may not bill for CPT psychotherapy codes (e.g., 90832).

Non-licensed providers rendering allowable HCPCS-coded services must have documented 1:1 supervision by an LMHP, meet required training and experience, and maintain qualifications annually (including completion of the non-licensed provider training on state and UnitedHealthcare sites).

Policy Summary

PayerOptum

PolicyLMHP provider requirements for billing and supervision (Louisiana)

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionEnsure CPT-coded services are rendered and billed only by an independently licensed LMHP and update agency roster on ProviderExpress within 10 days of licensed staff changes.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Allowed and Restricted Codes

Examples of CPT codes (not allowed for non-licensed providers)CPTNot Covered

90832

Example psychotherapy CPT code that cannot be billed by non-licensed provider

Examples of allowable HCPCS codes for non-licensed providersHCPCSCovered

H2017	Psychosocial Rehabilitation — example allowable for master's level social worker
H0004	Allowable HCPC Codes (listed in fee schedule)
H0011	Allowable HCPC Codes (listed in fee schedule)
H0012	Allowable HCPC Codes (listed in fee schedule)
H0018	Allowable HCPC Codes (listed in fee schedule)
H0019	Allowable HCPC Codes (listed in fee schedule)
H0039	Allowable HCPC Codes (listed in fee schedule)
H2011	Allowable HCPC Codes (listed in fee schedule)
H2033	Allowable HCPC Codes (listed in fee schedule)
H2036	Allowable HCPC Codes (listed in fee schedule)

1–10 of 16

1/2

Supervision ratio (inv-03)

Required supervision ratio1:1 documented supervision by an LMHP for all non-licensed providers rendering allowable HCPCS-coded services

Documentation requirementSupervision must be documented (records of 1:1 supervision retained)

Training and experienceNon-licensed providers must meet training and experience requirements and maintain qualifications annually

Required Provider Actions and Documentation

Documentation Required

Assessment and Medical Necessity Responsibility

All services billed with CPT codes on the Louisiana fee schedule must be rendered by an independently licensed clinician who is a Licensed Mental Health Professional (LMHP). Only LMHPs may conduct assessments, determine medical necessity, and must physically sign and date assessments and plans as required by the Louisiana Medicaid State Plan and the Louisiana Behavioral Health Partnership Service Definition Manual. The State Plan requires that medical necessity for mental health services be determined by a LMHP or physician acting within their scope of licensure. For crisis intervention, the assessment of risk, mental status, and medical stability must be completed by a LMHP or PIHP-designated LMHP with appropriate experience; this assessment should occur within a reasonable time based on the circumstances of the crisis.

Prior Authorization

Roster Maintenance

Maintain an accurate, up-to-date roster of licensed staff in your agency account on ProviderExpress. Any change to licensed staff (additions, removals, changes in licensure) must be reflected on the roster within 10 days of the change. Keeping the roster current is required and supports compliance with LMHP responsibility for assessments, supervision oversight, and credentialing.

Update roster within 10 days of any licensed staff change
Ensure roster reflects current LMHPs responsible for assessments and supervision

Key Roles & Terms

LMHP — definition (inv-09)

DefinitionLicensed Mental Health Professional (LMHP) — an independently licensed clinician authorized to render and bill services on the Louisiana Department of Health fee schedule

Billing and service scopeAll services billed with CPT codes on the Louisiana fee schedule must be rendered by an LMHP; non-licensed providers may not render these CPT services even if supervised

Assessments and medical necessityOnly LMHPs may conduct assessments and must physically sign and date the assessment

Non-licensed provider — definition & scope (inv-10)

DefinitionNon-licensed provider — provider with master’s level, bachelor’s level, or less than bachelor’s education who may render only specified HCPCS-coded services per the Louisiana Department of Health fee schedule

Scope of servicesMay render only the specific HCPCS codes listed on the state fee schedule (examples include H2017 for psychosocial rehabilitation); they may NOT bill CPT psychotherapy codes such as 90832

Supervision & trainingMust receive documented 1:1 supervision from an LMHP, complete required training (including non-licensed provider training available on state and UnitedHealthcare websites), and maintain qualifications annually