North Carolina Association of Professional Psychologists

Relatively few people who need the services of a psychologist can afford to pay for those services privately. To maintain a viable practice, psychologists working in both publicly-funded and private settings must be eligible to receive reimbursements from third-party payors.

Most health insurance companies now use a managed health care model. In deciding which mental health care providers qualify to be reimbursed for their services, many have adopted criteria of the National Committee for Quality Assurance, which accredits managed care companies.

NCQA stipulates providers be able to practice independently, without supervision, effectively excluding North Carolina’s master’s-level psychologists from providing services through managed care insurance plans because they are not licensed independently, even when they are employed and supervised by PhDs.

Other master’s-level practitioners in fields such as social work, nursing or pastoral counseling are allowed to practice independently and so are included on provider panels. Licensed psychologists who have doctorate degrees are included on provider panels as well and can be reimbursed for providing services qualified master’s-level psychologists also provide, often at a lower cost.

Medicare directly reimburses only physicians, doctoral-level psychologists and social workers.

Medicaid reimburses licensed master’s-level psychologists who apply and are approved as providers.

Master’s-level psychologists working in public schools, corrections and MR facilities are relatively insulated from third-party reimbursement restrictions. The hardest-hit practitioners work for area programs, hospitals, non-government health care providers and private clinics.

Because of the career-long supervision requirement imposed on LPAs, insurers have excluded them from provider panels, denying people who need their help access to their services and making employers reluctant to hire LPAs.