Does PerformCare PA Allow Supervised Therapist Billing?

Yes, conditionally. PerformCare Pennsylvania HealthChoices documents a pathway for services by supervised staff billed through a credentialed, Medical Assistance-enrolled psychologist’s MA identification number (MAID). It is not blanket permission for any unlicensed therapist: qualifications, supervision, an individual attestation and PerformCare approval matter. The current attestation says the practitioner must not see members until approval is communicated.

Which licenses and unlicensed staff are named?

The provider manual names LSW, LCSW, LPC, LMFT and unlicensed practitioners in the psychologist-supervised arrangement. Its graduate-psychology pathway requires qualifying graduate training; it is not satisfied by any unrelated graduate degree. The manual explains that qualifying coursework can include terminal master’s programs and does not require enrollment in a doctoral program.

The January 28, 2025 attestation names these therapy licenses and unlicensed master’s-level practitioners, and also lists CRNP and PA. Those additional categories are not a general psychotherapy authorization. Every person must meet the applicable professional requirements and the conditions of the actual service.

Is an ordinary student covered?

Student status alone is insufficient. The unlicensed employment standard in 49 Pa. Code §41.58 concerns persons with the required graduate training in psychology. It expressly separates people completing experience requirements for psychology licensure, professionals regulated by other boards and exempt settings. Do not apply that one section as the sole qualification rule for every licensed or prelicensed person on the payer’s form.

What must happen before the first visit?

The supervising psychologist must be credentialed by PerformCare and enrolled in Pennsylvania Medical Assistance. Submit an attestation and resume for each supervised practitioner. The current form requires primary-source education verification, documentation of qualifications and sanction checks, required training and ongoing supervision. It also requires education documentation to be provided to PerformCare. Submission alone is not approval.

What are the supervision limits?

The manual limits the licensed MA-enrolled psychologist to three full-time-equivalent supervised staff when billing Medical Assistance or PerformCare. This arrangement cannot be used to bypass outpatient-clinic licensing.

For employees governed by §41.58, the psychologist retains professional responsibility, provides regular face-to-face consultation and remains available for emergencies. The employee’s supervised status must be disclosed to patients and in billing. The employee signs records; communications sent outside the setting also require the supervisor’s reviewed-and-approved countersignature.

Whose identifier is used on the claim?

The manual and attestation expressly authorize applicable services through the supervising psychologist’s MAID. They do not supply a complete electronic rendering-NPI or modifier specification for every service. Do not turn the MAID instruction into an invented claim-field mapping, omit the actual practitioner from documentation, or assume the arrangement bypasses covered-service and authorization requirements.

Which PerformCare program and policy dates apply?

This answer covers Pennsylvania HealthChoices, not PerformCare New Jersey. Checked October 30, 2026, the Pennsylvania provider site still links the manual labeled updated February 2023; the psychologist attestation is updated January 28, 2025. The manual identifies PerformCare-HealthChoices payer ID 65391. The review date is not a new policy effective date, and a payer ID alone does not establish a member’s benefit or practitioner approval.

PerformCare Pennsylvania provider resources and current manual link

HealthChoices provider manual, printed page 29

Licensed Psychologist Attestation, updated January 28, 2025

Pennsylvania psychologist employment and supervision standard, §41.58

Frequently Asked Questions

Does PerformCare PA allow unlicensed therapists under a psychologist?

It documents a qualified supervised-staff pathway, not a blanket unlicensed category. Graduate-psychology and applicable professional requirements, an individual attestation, payer approval and required supervision must be satisfied.

Can an LSW, LPC or LMFT use this arrangement?

The manual names those licenses, along with LCSW, in the psychologist-supervised pathway. Listing a license does not replace individual approval, professional scope or the service’s coverage requirements.

Can the practitioner start once the attestation is submitted?

No. The January 2025 form says the person must not see PerformCare members until notified of PerformCare approval.

Does the policy specify supervisor rendering NPI and a modifier?

It specifies billing applicable services through the psychologist’s MAID. The reviewed passages do not establish a universal electronic rendering-NPI and modifier combination.