Texas Association of Psychological Associates
Representing All Masters-Degreed Psychology Professionals in Texas
FAQs - 2018
Representing All Masters-Degreed Psychology Professionals in Texas
FAQs - 2018
T.A.P.A.
P.O. Box 601374
Dallas, TX 75360
P.O. Box 601374
Dallas, TX 75360
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Frequently Asked Questions Email #2 - April 29, 2018
We are continuing to hear questions from many of you. We have been trying to get some definitive answers, but we have delayed getting this out long enough. These are some of the most frequent questions so far. We will give you the information that we know.
Q. Now that LPAs have independent practice, when will we be able to bill Medicaid, insurance companies, etc.?
A. Just because we have independent practice does not mean that third-party payment will come automatically. Our Lobbyist/Consultant is helping TAPA work through the bureaucratic maze in Austin to make sources of payment open to LPAs.
• Medicaid - LPAs have been in the Medicaid rules for some time, but under supervision. It will take a change in the rules to remove the supervision requirement. Changing rules must go through a process of proposal, posting in the Texas Register for comment by the public, and further review of comments. If the proposed rules are altered, then they must be posted for public comment again – and the process continues until the rules are finalized and voted on. At best, it is a lengthy process – and with rules as large and complex as the Medicaid rules, it is not undertaken lightly.
• Insurance - LPAs have been in the Insurance Code for many years, but under supervision. The Insurance Code is statute, so it will take a bill in the next Legislature, in 2019, to remove the supervision requirement.
• Agencies - Each state and local agency has its own rules designating who they can hire. To change these rules, there must be a process within the agency similar to that for changing the rules for Medicaid. Smaller agencies may be able to make changes more quickly, but at best, it still takes much longer than we would wish.
Q. If I cannot bill for myself, may my Supervisor continue to bill for me?
A. Yes. The Medicaid Rules have NOT yet changed. Until they do, the current rules still apply. While not optimal or our first choice, your supervisor may continue to bill for you as long as you are continuing to work for him/her.
Q. I see ads for LPCs, SWs, etc. but not LPAs. Why not?
A. Whoever put out the ad just may not know that LPAs may now work without supervision. We are encouraging all of you, if you see an ad that does not include LPAs, to give the hiring advertiser a call or to send an email explaining that LPAs no longer need supervision. If they ask for verification, refer them to the TSBEP website, https://www.tsbep.texas.gov/new-developments-and-requirements.
Especially if it is a job for which LPAs would be ideally suited, the hiring entity may work to change their rules or assist in enabling the LPA to take the job.
We all must work to get the word out! However, more jobs slowly are becoming available. "Indeed" and some of the online job search sites are starting to list jobs for LPAs.
Q. I want to start my own practice, but where do I start?
A. The first step to receiving third-party reimbursement is to get an NPI (National Provider Identifier). Once you have that, you will need a TPI (Texas Provider Identifier).
We are encouraging any LPA who is considering becoming a provider to start the process of getting your NPI.
Q. How do I get an NPI and what taxonomy code do I use?
A. The NPI is obtained through the Centers for Medicaid and Medicare (CMS) National Plan and Provider Enumeration System (NPPES) at https://nppes.cms.hhs.gov/. You must fill out and submit the online form.
Individuals are Type I Providers. Type 2 providers are organizations, like clinics, labs, etc.
When requesting an NPI, you must choose a "taxonomy" code or category for your services. The Taxonomy Code is just a code for What You Do. A list of the Behavior Health Codes is here. It comes from the current Handbook. You can download the 196-page book at- www.findacode.com/pdf.html?id=taxonomy-codes-2018-180 - but this includes ALL the medical codes, etc.
The instructions says that the codes are self-selected and that you choose the one most like what you do. There are other codes than just these in the Behavioral Health and Social Services category, e.g. behavior analyst, marriage and family therapist, psychoanalyst, etc, You may want to review all the options here.
Psychologist says-
Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. Notes: Source: American Psychological Association [1/1/2007: modified definition]
There is NOTHING there that says anything about what Degree you have. LPAs are licensed to practice psychology according to the Psychology Act.
[Alternatively, the definition for Clinical Neuropsychologist states you must have a doctorate.]
There is also a definition for Counselor- A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a masters degree and clinical experience and supervision for licensure or certification. Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.
The definition for Counselor is more limited – but it may fit best what You do. It seems like Psychologist is the more comprehensive definition most descriptive of what many LPAs do. It does NOT mean you can call yourself a Psychologist! It is simply a description of the type of services you will provide. In Texas LPAs would have a Texas Provider Number as an LPA.
There is a Code for School Psychologist, but it has not yet been defined. Nevertheless, in Texas LSSPs may provide services ONLY in public or private schools, and NOT in private practice. Therefore they would have no need or opportunity to bill.
So, you must select the Code which you feel best represents what services you are hoping to provide your clients.
Please let us know here if you have your NPI or if you had any difficulty in obtaining one.
Q. Are there limitations on the services I may provide my clients?
A. Yes and No. There are NO limitations on your scope of practice in the Psychology Act or in the Rules, OTHER THAN the exceptions given below and that you work in your area of competence. You must work in those areas in which you have training and experience. LPAs work in many different places and with clients with a variety of disabilities and/or disorders, so there is NO one set of approved services.
You may work with any client and provide any service if you are competent to do so. The ONLY exceptions are that LPAs may not conduct child custody or adoptions evaluations, competency or insanity evaluations, or fitness for duty evaluations for law enforcement personnel. These restrictions appear in the laws governing each of these areas.
Q. What can I do to help?
A. Join TAPA! We are working on your behalf. See the information in the column on the left on how to join by check or by PayPal. We'd like to have you as a Member! Thank you to those of you who have joined!
TAPA has formed an LPA Resource Group on Facebook. All LPAs are invited to join here.
As more LPAs develop their own websites, we will start a page to post links. So far, we have only received a few, but we know there will be more! We can provide resources for affordable do it yourself websites, if you need them.
If you have not already viewed this video, we encourage you to do so:
Office of the Governor and Attorney General Training Video to Combat Human Trafficking
Governor Greg Abbott and Attorney General Ken Paxton have joined forces to put together a training video teaching state employees how to recognize and report suspected human trafficking. The Board would like to take this opportunity to provide its licensees, applicants, and members of the public with a link to this video and training as well. The training video entitled Be the One in the Fight Against Human Trafficking, along with other related training information, can be found by clicking here.
- - - - - - - - - - -
Frequently Asked Questions Email #1 - February 5, 2018
We have heard from many of you who have questions, and there are many questions that will need answers now and in the future. These are some of the most frequent questions so far. We anticipate more FAQs and responses in the future
Q. I believe I qualify for independent practice, but have not received my new license. Why?
A. You will need to contact the TSBEP to see why. There may have been an error in their database, or it may have been mis-delivered, or there may be other reasons. The TSBEP sent them out, so they will know.
Q. I contacted the TSBEP and was told that my license was delinquent because I was late renewing. However, I renewed within a few weeks and was never notified my license was delinquent, so wasn't it active?
A. No. The rules require licensees to renew their licenses in a timely manner. Your license goes delinquent if you do not renew by the last day of your birth month. It does not matter that you renewed and paid the late fee before you were notified of a delinquent license; it was still delinquent.
Q. What should I do? Does that mean I cannot get a license with Independent Practice?
A. The good news is that you can apply for a License with Independent Practice using the Application for the LPA License With Independent Practice on the TSBEP website under Forms.
Q. I am an LPA, but do not have the necessary years of experience yet, what should I do?
A. The Application for the LPA License With Independent Practice has been posted on the TSBEP website under Forms. There are NO additional requirements other than obtaining the necessary years of supervised experience.
Q. Are there limitations on the services I may provide my clients.
A. Yes and No. There are NO limitations on your scope of practice in the Psychology Act or in the Rules, OTHER THAN that you work in your area of competence. You must work in those areas in which you have training and experience. LPAs work in many different places and with clients with a variety of disabilities and/or disorders, so there is NO one set of approved services.
You may work with any client and provide any service if you are competent to do so. The ONLY exceptions are that LPAs may not conduct child custody or adoptions evaluations, competency or insanity evaluations, or fitness for duty evaluations for law enforcement personnel. These restrictions appear in the laws governing each of these areas.
Q. How do I receive third-party payments?
A. Each third-party Payor, Medicaid, each insurance company, each HMO, Tri-care, etc. has its own set of requirements and process for approval. Many have more information on their websites, including the application for approval. If any of them ask for verification of your independent status, refer them to the TSBEP website or send them a copy of our statement, dated December 1, here.
If you do not already have an NPI [National Provider Identifier], you likely will need to apply for one. A National Provider Identifier or NPI is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). You will need it to use on claim forms submitted to payors. You can apply at https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/apply.html
Q. Can I bill Medicaid?
A. Not yet. This is NOT automatic just because we have independent practice. Our Lobbyist/Consultant is working in Austin to determine what is necessary to become independent Providers. Many of us have been listed as providers under supervision. The application is on the Texas Medicaid and Healthcare Partnership website, http://tmhp.com/Pages/ProviderEnrollment/PE_Home.aspx/
We will let you know, if we have more information.
Q. If I cannot bill for myself, may my Supervisor continue to bill for me?
A. Yes. The Medicaid Rules have NOT changed. Until they do, the current rules still apply. Your supervisor may continue to bill for you as long as you are continuing to work for him.
There is nothing in the new LPA Rules that say an LPA cannot work under supervision if they wish to continue to do so.
Q. What about the state agencies, DADS, Community Mental Health Centers, Juvenile Justice, Probation, etc.?
A. Some of you may remember that many LPAs worked in these agencies prior to their shifts in funding. Now that we may practice independently, jobs in these agencies should be open to us. Our Lobbyist/Consultant in Austin also is looking into some of these agencies.
However, if any of you have applied and have been hired by one of these agencies or have met specific resistance because you are an LPA, please email us here. We want to remove roadblocks for employment for LPAs, and we want to share information among LPAs to avoid having LPAs re-invent the wheel in different part of the state.
Q. Can I be reimbursed by Medicare?
A. Not to our knowledge. Unlike Medicaid which is administered by each state which may make adjustments appropriate to the state, Medicare is administered federally, and limits providers to Licensed Clinical Psychologists (PhD) and Social Workers. While that may change in the future, it has not changed since Medicare was first adopted.
Q. What can I do to help?
A. Join TAPA! We are working on your behalf. See the information in the column on the left on how to join by check or by PayPal. We'd like to have you as a Member! Thank you to those of you who have joined!
We are continuing to hear questions from many of you. We have been trying to get some definitive answers, but we have delayed getting this out long enough. These are some of the most frequent questions so far. We will give you the information that we know.
Q. Now that LPAs have independent practice, when will we be able to bill Medicaid, insurance companies, etc.?
A. Just because we have independent practice does not mean that third-party payment will come automatically. Our Lobbyist/Consultant is helping TAPA work through the bureaucratic maze in Austin to make sources of payment open to LPAs.
• Medicaid - LPAs have been in the Medicaid rules for some time, but under supervision. It will take a change in the rules to remove the supervision requirement. Changing rules must go through a process of proposal, posting in the Texas Register for comment by the public, and further review of comments. If the proposed rules are altered, then they must be posted for public comment again – and the process continues until the rules are finalized and voted on. At best, it is a lengthy process – and with rules as large and complex as the Medicaid rules, it is not undertaken lightly.
• Insurance - LPAs have been in the Insurance Code for many years, but under supervision. The Insurance Code is statute, so it will take a bill in the next Legislature, in 2019, to remove the supervision requirement.
• Agencies - Each state and local agency has its own rules designating who they can hire. To change these rules, there must be a process within the agency similar to that for changing the rules for Medicaid. Smaller agencies may be able to make changes more quickly, but at best, it still takes much longer than we would wish.
Q. If I cannot bill for myself, may my Supervisor continue to bill for me?
A. Yes. The Medicaid Rules have NOT yet changed. Until they do, the current rules still apply. While not optimal or our first choice, your supervisor may continue to bill for you as long as you are continuing to work for him/her.
Q. I see ads for LPCs, SWs, etc. but not LPAs. Why not?
A. Whoever put out the ad just may not know that LPAs may now work without supervision. We are encouraging all of you, if you see an ad that does not include LPAs, to give the hiring advertiser a call or to send an email explaining that LPAs no longer need supervision. If they ask for verification, refer them to the TSBEP website, https://www.tsbep.texas.gov/new-developments-and-requirements.
Especially if it is a job for which LPAs would be ideally suited, the hiring entity may work to change their rules or assist in enabling the LPA to take the job.
We all must work to get the word out! However, more jobs slowly are becoming available. "Indeed" and some of the online job search sites are starting to list jobs for LPAs.
Q. I want to start my own practice, but where do I start?
A. The first step to receiving third-party reimbursement is to get an NPI (National Provider Identifier). Once you have that, you will need a TPI (Texas Provider Identifier).
We are encouraging any LPA who is considering becoming a provider to start the process of getting your NPI.
Q. How do I get an NPI and what taxonomy code do I use?
A. The NPI is obtained through the Centers for Medicaid and Medicare (CMS) National Plan and Provider Enumeration System (NPPES) at https://nppes.cms.hhs.gov/. You must fill out and submit the online form.
Individuals are Type I Providers. Type 2 providers are organizations, like clinics, labs, etc.
When requesting an NPI, you must choose a "taxonomy" code or category for your services. The Taxonomy Code is just a code for What You Do. A list of the Behavior Health Codes is here. It comes from the current Handbook. You can download the 196-page book at- www.findacode.com/pdf.html?id=taxonomy-codes-2018-180 - but this includes ALL the medical codes, etc.
The instructions says that the codes are self-selected and that you choose the one most like what you do. There are other codes than just these in the Behavioral Health and Social Services category, e.g. behavior analyst, marriage and family therapist, psychoanalyst, etc, You may want to review all the options here.
Psychologist says-
Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. Notes: Source: American Psychological Association [1/1/2007: modified definition]
There is NOTHING there that says anything about what Degree you have. LPAs are licensed to practice psychology according to the Psychology Act.
[Alternatively, the definition for Clinical Neuropsychologist states you must have a doctorate.]
There is also a definition for Counselor- A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a masters degree and clinical experience and supervision for licensure or certification. Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.
The definition for Counselor is more limited – but it may fit best what You do. It seems like Psychologist is the more comprehensive definition most descriptive of what many LPAs do. It does NOT mean you can call yourself a Psychologist! It is simply a description of the type of services you will provide. In Texas LPAs would have a Texas Provider Number as an LPA.
There is a Code for School Psychologist, but it has not yet been defined. Nevertheless, in Texas LSSPs may provide services ONLY in public or private schools, and NOT in private practice. Therefore they would have no need or opportunity to bill.
So, you must select the Code which you feel best represents what services you are hoping to provide your clients.
Please let us know here if you have your NPI or if you had any difficulty in obtaining one.
Q. Are there limitations on the services I may provide my clients?
A. Yes and No. There are NO limitations on your scope of practice in the Psychology Act or in the Rules, OTHER THAN the exceptions given below and that you work in your area of competence. You must work in those areas in which you have training and experience. LPAs work in many different places and with clients with a variety of disabilities and/or disorders, so there is NO one set of approved services.
You may work with any client and provide any service if you are competent to do so. The ONLY exceptions are that LPAs may not conduct child custody or adoptions evaluations, competency or insanity evaluations, or fitness for duty evaluations for law enforcement personnel. These restrictions appear in the laws governing each of these areas.
Q. What can I do to help?
A. Join TAPA! We are working on your behalf. See the information in the column on the left on how to join by check or by PayPal. We'd like to have you as a Member! Thank you to those of you who have joined!
TAPA has formed an LPA Resource Group on Facebook. All LPAs are invited to join here.
As more LPAs develop their own websites, we will start a page to post links. So far, we have only received a few, but we know there will be more! We can provide resources for affordable do it yourself websites, if you need them.
If you have not already viewed this video, we encourage you to do so:
Office of the Governor and Attorney General Training Video to Combat Human Trafficking
Governor Greg Abbott and Attorney General Ken Paxton have joined forces to put together a training video teaching state employees how to recognize and report suspected human trafficking. The Board would like to take this opportunity to provide its licensees, applicants, and members of the public with a link to this video and training as well. The training video entitled Be the One in the Fight Against Human Trafficking, along with other related training information, can be found by clicking here.
- - - - - - - - - - -
Frequently Asked Questions Email #1 - February 5, 2018
We have heard from many of you who have questions, and there are many questions that will need answers now and in the future. These are some of the most frequent questions so far. We anticipate more FAQs and responses in the future
Q. I believe I qualify for independent practice, but have not received my new license. Why?
A. You will need to contact the TSBEP to see why. There may have been an error in their database, or it may have been mis-delivered, or there may be other reasons. The TSBEP sent them out, so they will know.
Q. I contacted the TSBEP and was told that my license was delinquent because I was late renewing. However, I renewed within a few weeks and was never notified my license was delinquent, so wasn't it active?
A. No. The rules require licensees to renew their licenses in a timely manner. Your license goes delinquent if you do not renew by the last day of your birth month. It does not matter that you renewed and paid the late fee before you were notified of a delinquent license; it was still delinquent.
Q. What should I do? Does that mean I cannot get a license with Independent Practice?
A. The good news is that you can apply for a License with Independent Practice using the Application for the LPA License With Independent Practice on the TSBEP website under Forms.
Q. I am an LPA, but do not have the necessary years of experience yet, what should I do?
A. The Application for the LPA License With Independent Practice has been posted on the TSBEP website under Forms. There are NO additional requirements other than obtaining the necessary years of supervised experience.
Q. Are there limitations on the services I may provide my clients.
A. Yes and No. There are NO limitations on your scope of practice in the Psychology Act or in the Rules, OTHER THAN that you work in your area of competence. You must work in those areas in which you have training and experience. LPAs work in many different places and with clients with a variety of disabilities and/or disorders, so there is NO one set of approved services.
You may work with any client and provide any service if you are competent to do so. The ONLY exceptions are that LPAs may not conduct child custody or adoptions evaluations, competency or insanity evaluations, or fitness for duty evaluations for law enforcement personnel. These restrictions appear in the laws governing each of these areas.
Q. How do I receive third-party payments?
A. Each third-party Payor, Medicaid, each insurance company, each HMO, Tri-care, etc. has its own set of requirements and process for approval. Many have more information on their websites, including the application for approval. If any of them ask for verification of your independent status, refer them to the TSBEP website or send them a copy of our statement, dated December 1, here.
If you do not already have an NPI [National Provider Identifier], you likely will need to apply for one. A National Provider Identifier or NPI is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). You will need it to use on claim forms submitted to payors. You can apply at https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/apply.html
Q. Can I bill Medicaid?
A. Not yet. This is NOT automatic just because we have independent practice. Our Lobbyist/Consultant is working in Austin to determine what is necessary to become independent Providers. Many of us have been listed as providers under supervision. The application is on the Texas Medicaid and Healthcare Partnership website, http://tmhp.com/Pages/ProviderEnrollment/PE_Home.aspx/
We will let you know, if we have more information.
Q. If I cannot bill for myself, may my Supervisor continue to bill for me?
A. Yes. The Medicaid Rules have NOT changed. Until they do, the current rules still apply. Your supervisor may continue to bill for you as long as you are continuing to work for him.
There is nothing in the new LPA Rules that say an LPA cannot work under supervision if they wish to continue to do so.
Q. What about the state agencies, DADS, Community Mental Health Centers, Juvenile Justice, Probation, etc.?
A. Some of you may remember that many LPAs worked in these agencies prior to their shifts in funding. Now that we may practice independently, jobs in these agencies should be open to us. Our Lobbyist/Consultant in Austin also is looking into some of these agencies.
However, if any of you have applied and have been hired by one of these agencies or have met specific resistance because you are an LPA, please email us here. We want to remove roadblocks for employment for LPAs, and we want to share information among LPAs to avoid having LPAs re-invent the wheel in different part of the state.
Q. Can I be reimbursed by Medicare?
A. Not to our knowledge. Unlike Medicaid which is administered by each state which may make adjustments appropriate to the state, Medicare is administered federally, and limits providers to Licensed Clinical Psychologists (PhD) and Social Workers. While that may change in the future, it has not changed since Medicare was first adopted.
Q. What can I do to help?
A. Join TAPA! We are working on your behalf. See the information in the column on the left on how to join by check or by PayPal. We'd like to have you as a Member! Thank you to those of you who have joined!