Aetna has updated their policy (February 2023) to allow for supervisory billing for behavioral health. (It’s about time!)
But, there are a few things you need to know:
First, let’s have a quick reminder of what supervisory billing is:
As a behavioral health provider, it’s crucial to understand the concept of supervisory billing. Supervisory billing refers to the process of billing for services provided by a supervisee under the supervision of a licensed behavioral health provider. The licensed provider assumes responsibility for the services provided by the supervisee and bills for those services on behalf of the supervisee.
Supervisory billing is common in behavioral health settings where a licensed provider supervises a trainee or an intern. This allows the trainee to gain valuable experience while providing services under the supervision of an experienced provider.
Supervisory billing is typically used in situations where the supervisee is not yet licensed or is working towards licensure. The licensed provider assumes responsibility for the services provided by the supervisee and ensures that the services meet the standard of care required by the state and federal laws.
When supervising a trainee, the licensed provider must ensure that the supervisee is providing services that are within their scope of practice and level of training. The licensed provider is responsible for providing feedback and guidance to the supervisee to ensure that they are providing quality services.
Billing for supervisory services can be complex and requires careful attention to detail. The licensed provider must ensure that the billing reflects the services provided by the supervisee, the supervision provided by the licensed provider, and the applicable billing codes.
The billing codes for supervisory services may vary depending on the state and the type of services provided. It’s essential to ensure that the billing codes used are appropriate for the services provided and comply with the state and federal regulations.
In conclusion, supervisory billing is an essential concept for behavioral health providers to understand. It allows trainees and interns to gain valuable experience while ensuring that the services provided meet the required standard of care. If you are a licensed provider who supervises a trainee, it’s crucial to understand the billing codes and regulations for supervisory services to ensure that you are billing appropriately and accurately.
You can read more on our blog here: Supervisory Billing
Aetna’s policy on Billing as Supervisor (a summary): the full policy in rather brief but is listed here: Aetna Supervisory Billing for Behavioral Health
Aetna allows supervisory billing for in-network behavioral health clinicians, supervisors, groups, and facilities to support providers and improve member access to care.
Supervisory billing is only allowed for qualified license-eligible behavioral health clinicians who have:
- completed all educational requirements for their target license type
- Are actively completing their clinical practice hours required for independent licensure
AND
- Are actively receiving clinical supervision from a qualified supervisor at a frequency and duration commensurate with their caseload.
How does Aetna define a Qualified Supervisor:
Qualified clinical supervisors are independently licensed behavioral health providers actively credentialed and contracted with Aetna.
Providers may submit claims for services delivered by license-eligible clinicians by listing the licensed supervisor as the rendering clinician, and prior authorization is not required for routine outpatient services such as psychotherapy and medication management.
Here’s the process required as we know it:
Supervisors who are in network can send a Letter of Intent to Aetna and list all Clinicians you wish to be affiliated and eligible to bill for services to Provider Network.
If you have questions, please call the Provider Contact Center at 1-888-MD AETNA (1-888-632-3862)(TTY: 711).
We have created a letter of intent to help that includes the necessary information. You can download a copy of our letter here:
FAQs:
Q: How do we submit supervisory claims:
A: Per our research these claims are submitted similar to the way Supervisory claims are submitted to Aetna.
The claims should be submitted with ONLY the supervisor’s name and NPI, NPI-2 for the organization and the EIN of the practice.
Q: How do we document that the claim was rendered by another clinician?
A: Your (internal) documentation including the intake and progress notes should indicate the rendering (supervisees) information. This is more of a documentation standard rather than a claims submission issue.
Q: Does this policy apply in all states?
A: To our knowledge, this is a nationwide policy. It is always best to call and verify if these rules apply to your state, licensure type and contract/entity type.