Provider Eligibility

Payment for the services described in 130 CMR 462.000 is made only to providers who are participating in MassHealth as of the date of service. The eligibility requirements are as follows. (A) In State. Licensed independent behavioral health clinicians are eligible to participate in MassHealth only if they are Medicare providers and are licensed to practice as a licensed independent behavioral health clinician as follows. (1) Licensed Independent Clinical Social Workers. An independent clinical social worker must be licensed by the Massachusetts Board of Registration of Social Workers to practice and engage in the independent practice of clinical social work pursuant to M.G.L. c 13, § 84 and 258 CMR 9.00: Licensure Requirements and Procedures. (2) Licensed Mental Health Counselors. A mental health counselor must be licensed by the Board of Registration of Allied Mental Health and Human Services Professions to provide counseling services pursuant to M.G.L. c. 112, § 165 and 262 CMR 2.00: Requirements for Licensure as a Mental Health Counselor. (3) Licensed Marriage and Family Therapists. A marriage and family therapist must be licensed by the Board of Registration of Allied Mental Health and Human Services Professions to provide therapeutic services pursuant to M.G.L. c. 112, §§ 163 through 172 and 262 CMR 3.00: Requirements for Licensure as a Marriage and Family Therapist. (B) Out of State. A licensed independent behavioral health clinician located outside Massachusetts is eligible to participate in MassHealth only if they are licensed to practice at the independent level by their state’s appropriate board of registration in their field and are a Medicare provider. Out-of-state licensed independent behavioral health clinical services are covered only as provided in 130 CMR 450.109: Out-of-state Services.