Marriage & Family Therapists and Mental Health Counselors: Enroll in Medicare Now to Become a Medicare Provider

The Centers for Medicare and Medicaid Services (CMS) will implement two new provider types on January 1, 2024:

1. Marriage & Family Therapist (MFTs)
   1. Possesses a master’s or doctor’s degree which qualifies for licensure or certification as a MFT pursuant to State law of the State in which such individual furnishes marriage and family therapist services.
   2. Is licensed or certified as a MFT by the State in which such individual furnishes such services.
   3. After obtaining such degree has performed at least 2 years of clinical supervised experience in marriage and family therapy; and
   4. Meets such other requirements as specified by the Secretary.
2. Mental Health Counselor (MHCs) – Including addiction counselors
   1. Possesses a master’s or doctor’s degree which qualifies for licensure or certification as a mental health counselor, clinical professional counselor, or professional counselor under State law of the State in which such individual furnishes MHC services.
   2. Is licensed or certified as a mental health counselor, clinical professional counselor, or professional counselor by the State in which the services are furnished;
   3. After obtaining such degree has performed at least 2 years of clinical supervised experience in mental health counseling; and            
   4. Meets such other requirements as specified by the Secretary.
   5. CMS will allow addiction counselors or drug and alcohol counselors who meet the applicable requirements to be an MHC to enroll in Medicare as MHCs

New in 2024 is the ability for MFTs and MHCs as well as addiction counselors who meet MHC requirements to enroll in Medicaid and bill for services starting January 1, 2024. Starting for dates of Service January 1, you can bill for services furnished for the diagnosis and treatment of mental illness. CMS Released a FAQ Sheet in September outlining additional information about how to enroll as a new Medicare MFT/MHC provider.

To enroll, providers must first complete the application. You can complete an electronic version of the application in PECOS or can submit a paper application by filling out the CMS-855I (PDF) paper application and mailing it to your local Part B Medicare Administrative Contractor (MAC). MACs are specific to the region where you practice and may have additional requests for information while they process your application. You can also contact your MAC if you need help enrolling, or for updates regarding your enrollment status.

Learn more about how to become a Medicare provider by visiting CMS’ website.