Effective April 1, 2023: New MMIS Requirement for LCSW, LMHC, and LMFT Providers
3/8/2023
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Posted by Provider Relations
Effective April 1, 2023, Fidelis will reimburse Licensed Clinical Social Workers (LCSWs), Licensed Mental Health Counselors (LMHCs), and Licensed Marriage and Family Therapists (LMFTs) in private practice settings.
In order to render services to Medicaid Managed members and receive reimbursement, LCSWs, LMHCs, and LMFTs must be enrolled with the NYS Medicaid FFS program and meet the NYS MMIS requirements. All claims will be denied if the MMIS requirement is not met by April 1, 2023.
This new requirement applies to providers servicing members enrolled in Fidelis Care Managed Care Plans, Health and Recovery Plans (HARP), Child Health Plus (CHP), and Managed Long Term Care Plans (LTC).
Information regarding how to enroll as a Medicaid provider, after choosing the appropriate provider type (Individual Billing Medicaid provider or Ordering, Prescribing, Referring, Attending (OPRA) provider), is available on the eMedNY “Provider Enrollment and Maintenance” web page, located at: https://www.emedny.org/info/ProviderEnrollment/index.aspx.
Questions and Additional Information:
Providers may check their enrollment status by reviewing the Medicaid Pended Provider Listing found here:
https://www.emedny.org/info/ProviderEnrollment/ManagedCareNetwork/index.aspx
Questions regarding the enrollment process, your enrollment status, or what you need to do to enroll, please contact providerenrollment@health.ny.gov or call the eMedNY Call Center at 1-800-343-9000.