Mental Health Provider Levels
Policy Number: GP-P-015
Last Updated: Oct. 6, 2022
Categorization of mental health providers occurs based on their level of training/education. Blue Cross and Blue Shield of Nebraska (BCBSNE) recognizes three levels of mental health providers: level I, level II and level III (auxiliary). See the below:
| Provider Level | Provider Type |
|---|---|
| Level I | Psychiatrist Licensed Clinical Psychologist Advanced Practice Registered Nurse Physician Assistant |
| Level II | Special Licensed Psychologist Licensed Mental Health Practitioner (LMHP) Licensed Alcohol and Drug Counselor (LADC) Licensed Independent Mental Health Practitioner |
| Level III | Auxiliary Providers Provisionally Licensed Mental Health Practitioners Provisionally Licensed Drug and Alcoholism Counselors Certified Social Workers Certified Masters Social Workers (CMSW) (without an LMHP license) |
Auxiliary Provider
All auxiliary (provisional) providers must be supervised by an in-network, qualified physician or licensed clinical psychologist or as otherwise permitted by state law. The provisional provider’s network status is directly tied to the participating status of the supervising provider.
Certified Master Social Workers or Certified Professional Counselors performing mental health services who are not LMHPs are included in this definition. Auxiliary providers need to provide BCBSNE with their professional information, so they can submit claims for services they are providing.
Once the provisional provider receives their full/active LMHP, LADC, LCSW, CMSW, PhD or PsyD, their provisional license becomes void, and BCBSNE will terminate the provisional status. The provisional provider will then need to be credentialed as a new provider.
Note: If a Provisionally Licensed Psychologist (PLP) is also an LMHP, we will continue to list the provider as an LMHP until they are fully licensed as a Licensed Psychologist. This is beneficial to the practitioner since the reimbursement for an LMHP is a Level II versus a Level III for a PLP. If a fully licensed provider wants to be listed as a provisional provider with BCBSNE, they must inactivate their current license with the state.
Note: If there are two therapists present in either an individual session or a group session, only one therapist can bill for their services.
As a provisional provider – if your supervisor terminates their agreement with BCBSNE you must provide us with your new supervisor’s information.