A new bulletin from the Centers for Medicare & Medicaid Services provides guidance on Medicare coverage of marriage and family therapists (MFTs), mental health counselors (MHCs), and intensive outpatient services for beneficiaries dually eligible for Medicare and Medicaid in 2024.
Medicare will begin covering these services and become the primary payer for dual-eligible beneficiaries effective Jan. 1, 2024. as authorized by the Consolidated Appropriations Act, 2023. These provisions were implemented in the calendar year 2024 Physician Fee Schedule and Hospital Outpatient Prospective Payment System final rules.
Medicare enrollment applications for MFTs and MHCs opened Nov. 2. Enrollment applications and retrospective billing may be effective up to 30 days prior to the submission of the Medicare enrollment application, but no earlier than Jan. 1, 2024.
States may choose to continue to pay for these services for a period in early 2024 while providers are enrolling as Medicare providers, or they can advise providers to hold claims and bill Medicare once they are enrolled.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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