Does MetroPlus Allow LMSW and Limited-Permit Therapy Billing?

Does MetroPlus cover therapy by an LMSW?

Yes, within the New York Medicaid, HARP and HIV SNP pathway in MetroPlusHealth’s June 7, 2023 memo. The memo permits supervised LMSW services and specifies the supervising LCSW’s NPI as the attending provider on the claim. It also names particular limited-permit pathways. This is not permission for every unlicensed therapist, every MetroPlus product or every practice setting.

Which licenses and permits qualify?

For an LMSW providing social-work services within lawful scope, the memo recognizes clinical supervision by an LCSW, licensed psychologist or psychiatrist. Its separate claim instruction is narrower: the supervising LCSW claims the service and supplies the attending NPI. The clinical-supervisor list does not itself establish a psychologist- or psychiatrist-NPI billing alternative.

What about limited permits?

The memo names LCSW and LMSW limited-permit holders working under an LCSW, LMHC limited-permit holders under an LMHC, and LMFT limited-permit holders under an LMFT. For each named pathway, the corresponding licensed supervisor claims the service with that supervisor’s NPI reported as attending. A student without one of those permits is not included merely because a supervisor is available.

Can the permit holder enroll and bill independently?

No independent enrollment route is established for limited-permit holders: the memo explicitly says they cannot enroll in New York Medicaid. It requires the licensed LCSW, LMHC or LMFT in the private-practice pathway to be licensed and registered with NYSED and enrolled in New York Medicaid fee-for-service. State enrollment alone does not establish a MetroPlus network agreement or coverage of every service.

Does the same rule apply in an Article 28 clinic?

Do not carry the private-practice claim arrangement into an Article 28 facility claim. The memo has a separate facility section, including practitioner affiliation in eMedNY and payment through the clinic rather than a separate professional claim. Its 2023 facility section also contains dated implementation language. This article does not certify that every facility restriction or rate instruction in that older section remains current; use the rules for the actual facility, service and date.

Which MetroPlus plans does this answer cover?

The memo explicitly covers Medicaid managed care, HARP and HIV SNP. It does not establish the same permission for MetroPlus commercial, Medicare, Essential Plan or other products. The June 2026 provider manual lists payer ID 13265 for multiple product groups, so a shared electronic payer ID cannot substitute for checking the member’s actual product.

Is the 2023 memo still linked by MetroPlus?

Yes. Checked October 30, 2026, MetroPlus’s behavioral-health resources page, labeled updated October 15, 2026, still links this exact memo with its April 1, 2023 effective date. That supports using the named supervised-clinician pathway as a current public lead; it does not turn the research date into a new policy effective date or prove every older facility provision unchanged.

MetroPlus supervised-clinician memo, page 1

MetroPlus current behavioral-health resources

MetroPlus June 2026 provider manual

Frequently Asked Questions

Whose NPI goes on a MetroPlus claim for an LMSW?

The reviewed Medicaid, HARP and HIV SNP memo says the supervising LCSW may claim the service with the LCSW’s NPI reported as attending. Its broader clinical-supervision list does not establish a different billing NPI.

Does MetroPlus cover an LMHC or LMFT limited-permit holder?

The memo names LMHC permit holders supervised by an LMHC and LMFT permit holders supervised by an LMFT, with the corresponding supervisor claiming the service and supplying the attending NPI. The permit holder cannot independently enroll in New York Medicaid.

Does the memo allow any graduate student to bill under a supervisor?

No blanket student pathway is established. The memo identifies LMSWs and specific limited permits; an unlicensed student without a named permit is not included just because supervision is available.