2.1 TRICARE Certified
Mental Health Counselor (TCMHC)
For the purposes
of TRICARE, a TCMHC is an independent provider who does not require referral
and oversight by a physician in order to receive reimbursement for
service to a beneficiary. A TCMHC must be licensed for independent
practice in mental health counseling by the jurisdiction where practicing.
In jurisdictions with two or more licenses allowing for differing
scopes of independent practice, the licensed mental health counselor
may only practice within the scope of licensure he or she possesses.
In addition, a TCMHC is an individual who:
2.1.1 Meets all of the following
requirements:
2.1.1.1 Has
passed the National Clinical Mental Health Counselor Examination
(NCMHCE) or an examination determined by the Director, Defense Health
Agency (DHA) as equal in scope, intent, and content to the NCMHCE;
and
2.1.1.2 Possesses a master’s or higher-level degree
from a mental health counseling program of education and training
accredited for Mental Health Counseling or Clinical Mental Health
Counseling by the Council for Accreditation of Counseling and Related
Educational Programs (CACREP);
OR otherwise meets
the requirements contained in paragraph 2.1.3; and
2.1.1.3 Has
a minimum of two years of post-master’s degree supervised mental
health counseling practice that includes a minimum of 3,000 hours
of supervised clinical practice and 100 hours of face-to-face supervision.
This supervision must be provided by mental health counselors, psychiatrists, clinical
psychologists, certified Clinical Social Workers (CSWs), TCMHCs,
or Certified Psychiatric Nurse Specialists (CPNSs) who are licensed
for independent practice in the jurisdiction where practicing and must
be practicing within the scope of their licenses. Supervision must
be conducted in a manner that is consistent with the guidelines
regarding knowledge, skills, and practice standards for supervision
of the American Mental Health Counselors Association (AMHCA): OR
2.1.2 Has met
the requirements identified in
paragraphs 2.1.2.1 or 2.1.2.2,
plus 2.1.2.3 at
any point prior to January 1, 2017
:2.1.2.1 Possesses
a master’s or higher-level degree from a mental health counseling
program of education and training accredited for Mental Health Counseling
or Clinical Mental Health Counseling by CACREP
(OR
otherwise meets the requirements contained in paragraph 2.1.3) and
has passed the National Counselor Examination (NCE)
or
NCMHCE;
or
2.1.2.2 Possesses
a master’s or higher-level degree from a mental health counseling
program of education and training accredited for Mental Health Counseling
or Clinical Mental Health Counseling from an
educational institution accredited by a Regional Accrediting Organization
recognized by the Council for Higher Education Accreditation and
has passed the NCMHCE; and
2.1.2.3 Has
a minimum of two years of post-master’s degree supervised mental
health counseling practice that includes a minimum of 3,000 hours
of supervised clinical practice and 100 hours of face-to-face supervision.
This supervision must be provided by mental health counselors, psychiatrists, clinical
psychologists, certified CCSWs, TCMHCs,
or CPNSs who are licensed for independent practice in the jurisdiction
where practicing and that is consistent
with the guidelines regarding knowledge, skills, and practice standards
for supervision of the AMHCA.
2.1.3 Pursuant
to Section 716 of the NDAA for FY 2016, prior to January 1, 2021,
an individual satisfies the requirement to “hold a master’s or higher-level
degree from a mental health counseling program of education and
training accredited for Mental Health Counseling or Clinical Mental
Health Counseling by CACREP” if the individual holds a master’s
degree or doctoral degree in counseling from a program that is accredited
by any of the following:
• Accrediting
Commission for Community and Junior Colleges Western, Association
of Schools and Colleges (ACCJC-WASC)
• Higher
Learning Commission (HLC)
• Middle
States Commission on Higher Education (MSCHE)
• New
England Association of Schools and Colleges Commission on Institutions
of Higher Education (NEASC-CIHE)
• Southern
Association of Colleges and Schools (SACS) Commission on Colleges
• WASC
Senior College and University Commission (WASC-SCUC)
• Accrediting
Bureau of Health Education Schools (ABHES)
• Accrediting
Commission of Career Schools and Colleges (ACCSC)
• Accrediting
Council for Independent Colleges and Schools (ACICS)
• Distance
Education Accreditation Commission (DEAC)
2.2 Supervised
Mental Health Counselor (SMHC)
For purposes
of TRICARE, an SMHC is an individual who does not meet the requirements
of a certified mental health counselor but meets the requirements
identified in
paragraphs 2.2.1 through
2.2.3 and
abides by the conditions of reimbursement identified in
paragraph 2.2.4.
The
SMHC:2.2.1 Possesses
a minimum of a master’s degree in mental health counseling or allied
mental health field from a regionally accredited institution; and
2.2.2 Has two
years of post-masters experience which includes 3,000 hours of clinical
work and 100 hours of face-to-face supervision; and
2.2.3 Is
licensed or certified to practice as a mental health counselor by
the jurisdiction where practicing; and
2.2.4 The
SMHC shall be reimbursed when
the following
criteria are met:
2.2.4.1 The TRICARE
beneficiary is referred for therapy by a physician; and
2.2.4.2 A physician
is providing ongoing oversight and supervision of the therapy being
provided; and
2.2.4.3 The SMHC certifies
on each claim for reimbursement that written communication has been made
or will be made to the referring physician of the results of the
treatment. Such communication will be made at the end of the treatment,
or more frequently, as required by the referring physician.
2.2.4.4 A
Licensed Psychological Associate (LPA) may continue to practice
as an SMHC upon meeting all requirements under 32 CFR 199.6(c)(3)(iv)(C). The
eligibility requirements for SMHCs did not change with the publication
of the Final Rule: “TRICARE; Certified Mental Health Counselors”
(76 FR 80741), effective August 18, 2014. These requirements include
licensure or certification in the provision of mental health counseling
(e.g., LPA; Licensed Professional Counselor (LPC)) by the jurisdiction
where practicing, in addition to the other requirements outlined
in the CFR regarding education and supervision. Providers who meet
the SMHC requirements provide services to beneficiaries under physician
referral and supervision.
2.2.4.5 The contractor shall provide reports as described
in the Contract Data Requirement List (CDRL).