PDF Version
TO: Federally Qualified Health Centers and
Rural Health Clinics
RE: FQHC and RHC Licensed Marriage and Family Therapists (LMFT) and Licensed
Professional Counselors (LPC) Enrollment and Billing Information
Effective January 1, 2024, Licensed Marriage
and Family Therapists (LMFT) and Licensed Professional Counselors (LPC) may now
enroll with the Alabama Medicaid Agency (Medicaid) and provide Behavioral
Health services in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics
(RHCs).
LMFTs (specialty 072) and LPCs (specialty
070) working in the FQHC and RHC setting must complete an individual within a
group provider enrollment application. Please visit the Electronic
Provider Enrollment Application Portal to submit an application. This
enrollment must be completed prior to providers rendering and receiving reimbursement
for Behavioral Health services. An unannounced site visit may be required as part
of the enrollment process. Site visits are unscheduled, unannounced visits
conducted by Gainwell Technologies Provider Representatives. If you are
selected for a visit, please take a few moments to answer the questions and
provide the additional documentation needed. For additional enrollment requirements,
please refer to section 34.1 of Chapter 34 of the Provider Billing Manual.
The CPT codes for billing are 90832, 90834,
90837, 90791 and 90785. These codes are inclusive of the PPS rate for the FQHC
and RHC facilities. Appropriate documentation must be documented in the medical
record. Documentation requirements can be found in Chapter 34 of the Provider Billing
Manual.
Chapters 16, 32, and 36 of the Provider Billing
Manual will be updated and published in the next provider manual update, scheduled
for July 2024.
If you have questions regarding this policy change,
please email Timikel Robinson at timikel.robinson@medicaid.alabama.gov.
For questions regarding enrollment, please
contact Provider Enrolment at 1-888-223-3630.
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2024 American Medical Association and © 2022 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.