Celebrating School Counselor Legitimacy: Changes in Medi-Cal Billing

Changes in Medi-Cal billing regulations will have lasting effects on the California school counseling profession.

Those who know me or have followed my work know I have made a life of believing and advocating for the prominence of school counselors in California schools. The advocacy comes from the belief that school counselors change lives and are well positioned to do so when they can do the work they have been trained to do and are not impeded by non-counseling duties. Last year these advocacy efforts culminated in the passage of AB 2508 (Quirk-Silva). This bill updated the CA Education Code 49600 to include provisions for direct services, pronouncing the role of school counselors in mental and behavioral health. Specifically, it clarifies a hotly contested assertion that school counselors are not mental health professionals, even though national organizations and federal law tell a different story.

Regulations associated with the passage of AB 2508 will be felt far and wide; however, the most pronounced change may be in school counselors’ ability to bill for Medi-Cal services. This is different from Medi-Cal LEA and Medi-Cal MAA billing.  This is equivalent to billing at the level of a clinician. A Department of Health Care Services (DHCS) notification recent bulletin indicates this change:

     To All Local Educational Agency (LEAs) Medi-Cal Billing Option Program (LEA BOP) Providers:

     The Department of Health Care Services (DHCS) is providing updates on credentialed school counselors’ scope of service and ability to bill for counseling under the LEA BOP. 

     Education Code Section 49600 defines scope of services for credential school counselors and was recently amended Assembly Bill 2508. The amendments become effective January 1, 2023. The Education Code previously limited covered services to mainly academic and career counseling services and the amendment adds direct services.

     1.  Due to this scope of services expansion, LEA BOP will reimburse psychology and counseling treatments provided by credentialed school counselors, for dates of service on and after January 1, 2023.  

     The Psychology/Counseling Section of the LEA BOP Provider Manual will be updated to reflect the following billing information under Psychology and Counseling Treatments.

Therefore, for all of you who have been told that it would benefit you to add an additional authorization, such as a Licensed Professional Clinical Counselor (LPCC), there is no longer a financial advantage for LEAs to have you do that. This does not mean school counselors change their practices; it means that the individual and group counseling services school counselors are already providing are now reimbursable at a rate commensurate with our licensed counterparts. Thus, the argument that one county superintendent said to me a few years ago, “we just can’t afford school counselors” due to the disadvantage of non-claimable activities, is now obsolescent!  This new provision may act as an incentive for administrators to suspend all the non-counseling duties performed by school counselors. We can hope! We can also let administrators know that the role out of this new law is forthcoming.

How this gets implemented is still in the infancy stage and more information and training will be forthcoming. I have been in touch with the DHCS for support. The CASC Board of Directors looks forward to supporting you and keeping you informed as we progress forward for California students.

Contact Loretta Whitson, Ed.D., CASC executive director, at executivedirector@schoolcounselor-ca.org.