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Licensed Clinical Social Worker Medicare Enrollment

Licensed Clinical Social Workers (LCSWs) can enroll directly in Medicare Part B and bill independently for mental health services. LCSWs were among the earliest non-physician mental health providers to gain independent Medicare status, and the scope of covered services has expanded in recent years.

Enrollment requirements

  • Master’s degree in social work from a CSWE-accredited program
  • Two years (3,400 hours) of post-master’s supervised clinical experience
  • State licensure at the independent practice level for clinical social work
  • Type 1 NPI (individual)
  • Enrollment via CMS-855I or PECOS

Covered services

Medicare Part B covers the following when provided by an enrolled LCSW:

  • Individual psychotherapy (90832, 90834, 90837)
  • Group psychotherapy (90853)
  • Family psychotherapy (90846, 90847)
  • Crisis psychotherapy (90839, 90840)
  • Psychiatric diagnostic evaluation (90791)

LCSWs cannot bill for psychological or neuropsychological testing — those remain limited to licensed psychologists and physicians.

No physician supervision required

LCSWs have full independent Medicare billing authority. A physician referral is not required for Original Medicare coverage. Medicare Advantage plans vary — some require authorization or referral for mental health services regardless of provider type.

Key applications

  • CMS-855I — individual enrollment
  • CMS-855R — reassignment to group (if applicable)

Ask Mae if you have questions about LCSW-specific documentation, scope of covered services, or group practice enrollment.