PDF Version

TO:  Federally Qualified Health Centers and Rural Health Clinics

RE: FQHC and RHC Licensed Marriage and Family Therapists (LMFT) and Licensed Professional Counselors (LPC) Enrollment and Billing Information

Effective January 1, 2024, Licensed Marriage and Family Therapists (LMFT) and Licensed Professional Counselors (LPC) may now enroll with the Alabama Medicaid Agency (Medicaid) and provide Behavioral Health services in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).

LMFTs (specialty 072) and LPCs (specialty 070) working in the FQHC and RHC setting must complete an individual within a group provider enrollment application. Please visit the Electronic Provider Enrollment Application Portal to submit an application. This enrollment must be completed prior to providers rendering and receiving reimbursement for Behavioral Health services. An unannounced site visit may be required as part of the enrollment process. Site visits are unscheduled, unannounced visits conducted by Gainwell Technologies Provider Representatives. If you are selected for a visit, please take a few moments to answer the questions and provide the additional documentation needed. For additional enrollment requirements, please refer to section 34.1 of Chapter 34 of the Provider Billing Manual.

The CPT codes for billing are 90832, 90834, 90837, 90791 and 90785. These codes are inclusive of the PPS rate for the FQHC and RHC facilities. Appropriate documentation must be documented in the medical record. Documentation requirements can be found in Chapter 34 of the Provider Billing Manual.

Chapters 16, 32, and 36 of the Provider Billing Manual will be updated and published in the next provider manual update, scheduled for July 2024.

If you have questions regarding this policy change, please email Timikel Robinson at timikel.robinson@medicaid.alabama.gov.

For questions regarding enrollment, please contact Provider Enrolment at 1-888-223-3630.

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2024 American Medical Association and © 2022 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.