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LCD ID Number: L34616 Status: A-Approved
LCD Title: Psychiatry and Psychology Services
Geographic Jurisdiction: Missouri - Entire State, Missouri - Northwestern Other Jurisdictions
Original Determination Effective Date:
10/01/2015
Original Determination Ending Date:
Revision Effective Date:
10/31/2024
Revision End Date:
CMS National Coverage Policy:
Social Security Act 1861(s) Medical and Other Health Services
42 CFR 410.73 – 410.76 describes coverage of services provided by clinical social workers, physician assistants, nurse practitioners, or clinical nurse specialists.
CMS Publication 100-02: Medicare Benefit Policy Manual, Chapter 15 – Covered Medical and Other Health Services:
§160 Clinical Psychologist Services
§170 Clinical Social Worker (CSW) Services
§180 Nurse-Midwife (CNM) Services
§190 Physician Assistant (PA) Services
§200 Nurse Practitioner (NP) Services
§210 Clinical Nurse Specialist (CNS) Services
§330 Marriage and Family Therapist (MFT) Services
§340 Mental Health Counselor (MHC) Services
CMS Publication 100-03: Medicare National Coverage Determinations (NCD) Manual, Chapter 1 – Coverage Determinations, Part 1:
§30.1 Biofeedback Therapy
CMS Publication 100-04: Medicare Claims Processing Manual, Chapter 12 – Physician/Nonphysician Practitioners:
§110 Physician Assistant (PA) Services Payment Methodology
§120 Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) Services Payment Methodology
§120.1 Limitations for Assistant-at-Surgery Services Furnished by Nurse Practitioners and Clinical Nurse Specialists
§150 Clinical Social Worker (CSW) Services
§160 Independent Psychologist Services
§170 Clinical Psychologist Services
§170.1 Payment
§210 Outpatient Mental Health Treatment Limitation
§240 Marriage and Family Therapist (MFT) Services
§250 Mental Health Counselor (MHC) Services
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