Andrea Wieland Oct 14, 2022 1:27:59 PM 3 min read

Behavioral Health Credentialing in Ohio

When considering credentialing behavioral health providers in Ohio, the most important thing to find out is if insurances enroll your provider type. All the behavioral health insurances we have worked with at MMG will credential and contract MDs and DOs. However, there are several license types that insurances will not enroll because they do not meet the level of education and experience requirements, or they are not independent licenses.

Medicare at this time will not credential counselors of any type, including Chemical Dependent Counselors (LICDC, LCDC 1-3) and Licensed Professional Counselors. It does not matter if they have an independent license or not. This policy means insurances like Anthem will only enroll counselors in their non-Medicare plans. While Anthem will enroll Independent Counselors (LICDC), they will not enroll that provider in their Medicare plan, just their commercial and Medicaid products.

Medicare will enroll LISW (Licensed Independent Social Workers) but not LSWs (Licensed Social Workers). This is because LISW licenses are independent, while LSWs are not.

Ohio Medicaid enrolls both counselors and social workers (LICDC, LCDC, LCDC 1, LCDC 2, LCDC 3, LSW, LISW, LPC, LPCC, and LPCC-S). If the provider applies for a higher-level license and receives it, this change would need to be updated by contacting Medicaid. Medicaid would then more than likely ask you to deactivate the provider’s current enrollment and submit a new application for the higher-level license.

Many of the commercial insurances follow Medicare’s example. They will enroll a provider with an independent license, but not a provider with a license that requires supervision.

If you have specific questions around credentialing various behavioral health provider types in Ohio, our team can help. Contact us to set up a conversation.