Updated CMS Resources For MFTs And MHCs

CMS’ Provider Relations Group and other divisions have updated content to include:

MHC and MFT Provider Enrollment Frequently Asked Questions (FAQs)

CMS has updated for a third time the FAQs document for MHCs and MFTs that contains information and specific guidance and links on:

• How does Medicare define MFTs and MHCs
• What are NPI and Taxonomy Codes
• Enrolling as an MFT and MHC
• How does an MFT and MHC access PECOS enrollment form
• Submitting multiple applications
• Electronic Funds Transfer
• Reassigning benefits
• Telehealth services
• Supervision requirements
• Revalidation
• Opt-out processes

For more FAQ information, please see:
https://www.cms.gov/files/document/marriage-and-family-therapists-and-mental-health-counselors-faq.pdf

Key CMS Resources

In addition to the updated FAQs document, please see the following CMS resources for your consideration:

Medicare & Mental Health Coverage Booklet
https://www.cms.gov/files/document/mln1986542-medicare-mental-health-coverage.pdf

Mental Health Counselors Web Page
https://www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/marriage-and-family-therapists-mental-health-counselors

Provider Enrollment Changes to the Medicare Program Integrity Manual Article
https://www.cms.gov/files/document/mm13331-provider-enrollment-changes-medicare-program-integrity-manual.pdf

Medicare Provider Enrollment Tool
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html

Opt-out of Medicare
https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/chain-ownership-system-pecos/manage-your-enrollment

MACs are required to use CMS’ national content, for consistency across MAC jurisdictions, to educate providers and CMS directs MACs to develop their own local educational content to supplement CMS content to address local coverage and jurisdiction needs based on their analysis of inquiries and claims errors.
https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/com109c06.pdf

Engaging with Medicare Administrative Contractors:

Each MAC has a Provider Customer Service Program (PCSP) to help providers understand and comply with Medicare’s operational processes, policies, and billing procedures. The PCSP consists of three major components: Provider Outreach and Education (POE), Provider Contact Center (PCC), and Provider Self-Service (PSS) Technology. Each of these areas provide avenues to address provider educational needs. 
https://www.cms.gov/medicare/coding-billing/provider-customer-service-program

MAC POE staff for each jurisdiction present education to groups or to individuals through a variety of communication channels and mechanisms including seminars, Web, telephone, face-to-face instruction, web-based training, and presentations in classrooms and other settings.  Through the MAC PSS Technology providers can access the MAC portals, web-based training, and other self-service tools.  If providers can’t find what they need through these platforms, the PCC is available to answer questions once providers submit a claim or if providers just need help with general information. Each MAC has a POE Advisory Group to help the MAC create, implement, and review provider education strategies and efforts. https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/com109c06.pdf

For more information on MAC POE Advisory Groups, please see:

CGS    https://www.cgsmedicare.com/partb/education/poeag.html

FCSO 
https://medicare.fcso.com/POE-AG/226699.asp

NGS   
https://www.ngsmedicare.com/poe-advisory-group?selectedArticleId=491187&lob=93617&state=97256&rgion=93623

Noridian JEB  
https://med.noridianmedicare.com/web/jeb/education/poe-advisory-group

Noridian JFB  
https://med.noridianmedicare.com/web/jfb/education/poe-advisory-group

Novitas JL     
https://www.novitassolutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00008205

Novitas JH 
https://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00024925

Palmetto GBA  https://www.palmettogba.com/palmetto/jmb.nsf/DID/8BZR9Z5304

WPS   
https://med.wpsgha.com/guides-resources/view/326

The attached document also provides information including links to provider request forms, schedules of events, and other ways to contact a specific MAC to address inquiries. file:///C:/Users/Joel%20Miller/Downloads/Contact%20Us%20Handout%2001162024%20(4).pdf

In addition to the attached document, the following link contains information on state-by-state MAC websites, secure Internet portals, and electronic mailing lists.
https://www.cms.gov/mac-info

Links to Resources on Older Adults

• Substance Abuse and Mental Health Services Administration, “ Older Adults Living with Serious Mental Illness: The State of the Behavioral Health Workforce” (2019)
• SAMHSA, “ Treating Substance Use Disorder in Older Adults” (2020)
• Health Solutions, Office of National Drug Control Policy, August 2011; Bailie, M., et al., “ Confronting Rural America’s Health Care Crisis,” Bipartisan Policy Center, Rural Mental Health (April 21, 2020) (recommending that LMFTs and LPCs be added to the list of Medicare providers as a method of increasing access to care, emphasizing that ensuring an adequate rural health workforce will help stabilize and reform the rural health infrastructure)
• Fullen, M., Lawson, G., Sharma, J., “ Analyzing the Impact of the Medicare Coverage Gap on Counseling Professionals: Results of a National Study,” Journal of Counseling and Development, Vol. 98 (March 8, 2020) (38.8% of the counselors surveyed referred existing clients to Medicare-covered when they became eligible for the program, and 39.9% agreed to see a Medicare-enrolled client pro bono or on a sliding scale)
• A recent PAN Foundation poll of 1,000 Medicare-covered older adults found that 67% said they would be comfortable seeking and receiving mental health care, despite one in five responding that their family members, friends, and acquaintances attached stigma to seeking treatment for mental health. In addition, 71% said they had never been screened by their providers for a mental health condition. PAN Foundation, “ Addressing the Gaps in Mental Health Coverage for Medicare Beneficiaries,” June 3, 2021
• Report to Congress, “ The Way Forward: Federal Action for a System That Works for All People Living with SMI and SED and Their Families and Caregivers,” SAMHSA, Interdepartmental Serious Mental Illness Coordinating Committee (2017), Recommendation 2.8(d), p.83
• “ The Collaborative Care Model: An Approach for Integrating Physical and Mental Health Care in Medicaid Health Homes,” Center for Health Care Strategies and Mathematica Policy Research, Health Home Information Resource Center (May 2013)
• Substance Abuse and Mental Health Services Administration, “ Older Adults Living with Serious Mental Illness: The State of the Behavioral Health Workforce” (2019)
• American Association for Marriage and Family Therapy, “ About Marriage and Family Therapists,” 2019
• Kaiser, Older Adults, 2020. According to a study from the National Academies of Sciences, Engineering, and Medicine, 43% of adults over 60 reported feeling lonely in February 2020, just before the scope of the pandemic became clear. National Academy of Sciences, “ Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System,” National Academies Press (February 27, 2020) 
• Institute of Medicine, “ The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?,” The National Academies Press (2012)
• Journal of Counseling & Development,  The impact of excluded providers on Medicare beneficiaries’ mental health care, (2021)