For Immediate Distribution
SUBJECT: Extension of Provisionally Licensed Providers Delivering Reimbursable Outpatient Therapy Services Billed Through the Local Management Entity (LME)
The purpose of this communication is to announce that the deadline for provisionally licensed providers delivering outpatient therapy as a reimbursable service under Medicaid and state funds and billed through the LME has been extended to June 30, 2010. Our Divisions will continue to pay for services delivered by provisionally licensed individuals billed through LMEs under codes H0001, H0004, and H0005 until that date.
As outlined in Implementation Update # 32, the LME may chose to provide this service on behalf of the provisionally licensed professional. If the provisionally licensed professional is employed by an agency, the agency must develop a contract directly with the LME to do this billing for them. If the provisionally licensed professional works independently, they should contact their licensure board prior to developing a contract with the LME to ensure compliance with each profession’s Scope of Practice.
In addition to providing outpatient services billed through an LME, there are various other means for provisionally licensed professionals to obtain the clinical experience required by their licensing boards. These include:
• providing outpatient Medicaid services working with a physician using Medicaid’s Incident To policy (see the March 2009 Medicaid Bulletin);
• providing Enhanced MH/DD/SA services as the Qualified Professional (QP) in order to receive family and community based clinical experience; and
• serving as the "Licensed Professional" in the Intensive In-Home service.