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Effective August 20, 2021, DMAS will allow licensed school psychologists to be reimbursed for psychiatric services (e.g. outpatient psychotherapy and assessment services) provided outside of the school setting in accordance with 12 VAC 30-50-150 D. Outpatient psychiatric services provided by licensed school psychologists must be within the scope of practice for school psychologists as defined by the Virginia Board of Psychology.  This allowance does not apply to individuals with a school psychologist limited license which is a separate and distinct license recognized by the Board of Psychology.

A list of approved outpatient psychiatric CPT codes and rates is available in the “VA DMAS Medicaid Rates” document on the Magellan of Virginia website at:  https://www.magellanofvirginia.com/for-providers/provider-tools/getting-paid/.  Licensed school psychologists will be reimbursed at 67.5% of the rate provided to psychiatrists, which is the rate listed in the master’s level column on the VA DMAS Medicaid Rates document.  Psychologists must be licensed as a licensed clinical psychologist to bill the rate listed in the psychologist column for outpatient psychiatric services.  Service requirements for outpatient psychiatric services are available in the Psychiatric Services Manual available on the DMAS website at https://www.virginiamedicaid.dmas.virginia.gov/wps/portal/ProviderManual/. 

Licensed school psychologists must be individually credentialed or work for an agency that is credentialed with Magellan of Virginia for individuals enrolled in Medicaid fee for service (FFS), or the individual’s Medicaid Managed Care Organization (MCO) for individuals enrolled in Medicaid managed care.  Information on credentialing with Magellan of Virginia is located at: https://www.magellanofvirginia.com/for-providers/join-the-network/.  Information on credentialing with the MCOs is available in the “Doing Business with CCC Plus and Medallion 4.0 MCOs” document located on the DMAS website at: https://www.dmas.virginia.gov/for-providers/behavioral-health/training-and-resources/.

Covered Medicaid services provided in the school setting by licensed school psychologists continue to be billed through the school division and remain unchanged at this time.  For additional information on allowed school services, see the Local Education Agency Manual available on the DMAS website at: https://www.virginiamedicaid.dmas.virginia.gov/wps/portal/ProviderManual/. 

For questions, please email: enhancedbh@dmas.virginia.gov

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