DETROIT – Blue Cross Blue Shield of Michigan is making a billing change and mental health care workers in the area say it could leave patients without their counselors. Additionally, mental health care workers say it could upend private practices’ way of making money.
The insurance company says they’re making the change to align with network policy and will make sure members receive the best care available.
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The changes are related to a policy called “incident-to” billing. Experts say it’s mostly used by private practices across the state.
Many of those providers opened their laptops on Monday to find an email that it would all be changing.
“A lot of people are going to lose access to their providers, who they’ve already built this relationship with, they feel safe with,” Katie Stetler, a local social worker, said. Additionally, her background is in medical billing.
Stetler is not alone in her concern.
“People who are currently seeing a limited license counselor would lose their therapist,” David Sniderman, a clinical mental health counselor and art therapist and WillowsEdge Counseling and Healing Arts Center, said.
Sniderman says “incident-to” billing has been the standard policy for private practices for over a decade.
“Fully licensed counselors sign off on limited counselors and interns for their billing purposes, so that they get supervision and they get their hours that they need to become fully licensed,” Sniderman said.
Mental health care workers in the area reached out to Local 4 and said people with limited licenses provide a significant portion of outpatient mental health services throughout the state while they complete the supervised training they need for their full license.
“We bill under our supervisor currently and so they are basically saying that unless you are in a facility, a mental hospital, something like that - that’s not going to be allowed anymore,” Stetler said.
“In service to our members, Blue Cross Blue Shield of Michigan reviews our payment policies on a regular basis to ensure they reflect the most up-to-date guidance and data,” BCBSM said. “Recent changes to Blue Cross’ ‘incident-to’ billing policy will ensure members receive the best possible care from fully licensed providers, while also allowing students, trainees and limited license professionals to be paid for services authorized and overseen by fully licensed providers in facility-based settings. Incident-to billing is a practice where a provider can bill under a fully licensed supervising provider’s National Provider Identifier number. This change will go into effect March 1, 2027, and will work to create a consistent approach to payment for all provider trainees who have not yet achieved full licensure. This will also align the Blue Cross policy with our Blue Care Network policy, which has never included students, trainees or limited license professionals for incident-to billing.”
“I think 42% see limited license counselors so those 42% would all immediately need a new counselor,” Sniderman said.
Providers say this would impact them too.
At WillowsEdge alone, Sniderman tells me over 50% of their revenue comes from BCBSM.
Providers worry about having to make cuts to limited license holders and the impact it could have on those with full licenses.
“A lot of us with limited licenses will be laid off,” Stetler said. “At least those who work for smaller private practices like the one that I work for.”