Licensed Mental Health Counselors (LMHCs) and Marriage and Family Therapists (MFTs) received Medicare provider status following the Consolidated Appropriations Act. LMHCs can now enroll in Medicare Part B and bill for mental health services — expanding access to behavioral health care and opening a new revenue stream for independent counseling practices.
Who qualifies
To enroll as an LMHC under Medicare:
- Hold a master’s or doctoral degree in mental health counseling or a related field
- Have at least 2 years (3,000+ hours) of supervised clinical experience post-degree
- Be licensed at the independent practice level in your state
- Have a state license that authorizes independent diagnosis and treatment of mental health conditions
Forms and enrollment sequence
- Verify your NPI — If you don’t have a Type 1 NPI, register at NPPES. Use taxonomy code 101YM0800X (Mental Health Counselor).
- Enroll via PECOS or file the CMS-855I. LMHCs are classified as non-physician practitioners — the enrollment application is the same CMS-855I used by other individual practitioners.
- Group practice enrollment — If you’re part of a group, the practice needs a CMS-855B and Type 2 NPI. File the CMS-855R to reassign your billing to the group.
Covered services
Medicare Part B covers:
- Individual psychotherapy (90832, 90834, 90837)
- Group psychotherapy (90853)
- Family psychotherapy (90846, 90847)
- Psychiatric diagnostic evaluation (90791, 90792)
- Crisis psychotherapy (90839, 90840)
⚠️ LMHCs cannot supervise other providers billing under incident-to rules. Each LMHC must bill under their own NPI.
Timeline
Enrollment processing: 30–60 days via PECOS. Ensure your state license is active and your NPPES taxonomy is correct before applying — incorrect taxonomy is the leading cause of LMHC enrollment rejections.
Ask Mae if you have questions about your specific enrollment situation as an LMHC.