Adding psychologists to the DC Medicaid provider network will expand access to care.

Independent practicing psychologists in Washington, D.C., may soon be able to bill Medicaid for providing mental health services to low- income residents — a move that would expand access to mental health care and substance abuse treatment services by enabling more psychologists to become Medicaid providers

This change could happen as early as January 2020 if the Centers for Medicare and Medicaid Services approves a waiver application submitted by D.C. Medicaid to expand reimbursement to independent practitioners.

Under existing policy, few D.C.-based psychologists are able to bill Medicaid. The psychologists who are reimbursed by D.C. Medicaid typically work in a health care facility or a community mental health center.

“This limitation on independently practicing psychologists billing Medicaid is seen in only six other states,” says Caroline Bergner, JD, APA’s legal and policy affairs officer. 

Psychologists will also be able to expand or diversify their practices by providing services to Medicaid recipients. “APA encourages psychologists to examine their practice and see if they can participate in the Medicaid program by including even just a few new Medicaid patients as part of their overall caseload,” Bergner said. (For more information listen to Progress Notes: Practicing Psychology in the Medicaid System.)

The D.C. Psychological Association (DCPA), with assistance from APA and APA Services, Inc., has advocated for reimbursement for practicing psychologists for several years, meeting repeatedly with the D.C. Department of Health Care Finance.

David Freeman, PsyD, vice president of DCPA’s community affairs and chief clinical officer at nonprofit mental health agency Community Connections, says Washington has a significant number of psychologists who are uniquely qualified to provide testing, treatment, mental health program design and outcome evaluation. Reimbursing for these benefits would help solve a large service gap in the area, Freeman said.

In a May 13 letter to CMS, APA and APA Services applauded the agency for considering the waiver and encouraged CMS to explore other pilot programs that would promote using supervised psychology trainees to provide services. APA and APA Services successfully set up a pilot project with AmeriHealth Caritas DC, the largest Medicaid managed care company in Washington, D.C. The project allows psychology trainees to bill Medicaid, and the hope is to expand that project to other states in the future.

Looking for Medicaid opportunities in your state?

APA and APA Services are collaborating with state psychological associations to encourage the greater inclusion of psychologists in Medicaid programs and reimbursement for services provided by supervised doctoral psychology trainees. If you, or your state psychological association, would be interested in opening up opportunities within your state’s Medicaid program, contact Caroline Bergner via email or by phone at (202) 336-5886.