| Is the Benefit Covered? |
Copayment Requirement |
Prior Approval Requirement |
Coverage Limitations |
Reimbursement Methodology |
Populations Covered |
|
|
Alabama
|
|
Yes
|
$1/visit
|
|
Specified set of procedures billable and only for diagnoses in 290-316 range, varying frequency limits
|
Fee for service
|
CN
|
|
Alaska
|
|
Yes
|
|
|
|
Fee for service
|
CN
|
|
Arizona
|
|
Yes
|
|
|
|
Fee for service
|
CN & MN
|
|
Arkansas
|
|
No
|
|
|
|
|
|
|
California
|
|
Yes
|
$1/visit
|
|
2 service sessions/month included in limits with other specified providers in any setting
|
Fee for service
|
CN & MN
|
|
Colorado
|
|
Yes
|
$2/office visit, $.50/15 minute psych service
|
|
|
Fee for service
|
CN
|
|
Connecticut
|
|
No
|
|
|
|
|
|
|
Delaware
|
|
Yes
|
|
|
20 outpatient visits/year included in limit with other mental health providers
|
Fee for Service
|
CN
|
|
District of Columbia
|
|
No
|
|
|
|
|
|
|
Florida
|
|
No
|
|
|
|
|
|
|
Georgia
|
|
No
|
|
|
|
|
|
|
Hawaii
|
|
Yes
|
|
Psychological testing
|
4 hours psychological testing/year with 2 additional hours for comprehensive testing
|
Fee for service
|
CN & MN
|
|
Idaho
|
|
No
|
|
|
|
|
|
|
Illinois
|
|
No
|
|
|
|
|
|
|
Indiana
|
|
Yes
|
|
Specified services including psychological testing
|
20 service/time units/year
|
Fee for service
|
CN
|
|
Iowa
|
|
Yes
|
$2/day
|
|
|
Fee for service
|
CN & MN
|
|
Kansas
|
|
Yes
|
$3/office visit
|
|
|
Fee for service unless included in behavioral health managed care contract
|
CN & MN
|
|
Kentucky
|
|
No
|
|
|
|
|
|
|
Louisiana
|
|
No
|
|
|
|
|
|
|
Maine
|
|
Yes
|
$.50-$2/day, depending on payment, up to $20/month
|
|
16 one-hour visits/year for individual or group counseling
|
Fee for service
|
CN & MN
|
|
Maryland
|
|
Yes
|
|
Yes
|
Service and visit limits vary based on medical need
|
Fee for service
|
CN & MN
|
|
Massachusetts
|
|
Yes
|
|
|
Limited to psychological testing and 1 testing session/6 months
|
Fee for service
|
CN & MN
|
|
Michigan
|
|
No
|
|
|
|
|
|
|
Minnesota
|
|
Yes
|
|
|
|
Fee for service
|
A & B - See state-specific FN
|
|
Mississippi
|
|
No
|
|
|
|
|
|
|
Missouri
|
|
Yes
|
$2/day
|
Yes
|
|
Fee for service
|
CN & MN
|
|
Montana
|
|
Yes
|
$3/visit
|
|
16 service sessions/year for adults and 24 for children
|
Fee for service
|
A & B - See state-specific FN
|
|
Nebraska
|
|
Yes
|
|
|
|
Fee for service
|
CN & MN
|
|
Nevada
|
|
Yes
|
|
Yes
|
Scope of coverage based on intensity of need
|
Fee for service
|
CN
|
|
New Hampshire
|
|
Yes
|
|
|
12 visits/year, psychotherapy visits included in limits with other specified practitioners, must be by independent psychologist
|
Fee for service
|
CN & MN
|
|
New Jersey
|
|
Yes
|
|
|
Psychotherapy services up to $900/year or $400 for nursing facility residents
|
Fee for service
|
CN & MN
|
|
New Mexico
|
|
Yes
|
A - $5/visit, B - $7/visit - see state-specific FN
|
Specified services
|
|
Fee for service
|
CN
|
|
New York
|
|
Yes
|
|
|
|
Fee for service
|
CN & MN
|
|
North Carolina
|
|
Yes
|
|
|
|
Fee for service
|
CN & MN
|
|
North Dakota
|
|
Yes
|
$2/visit
|
|
40 psychotherapy visits/year
|
Fee for service
|
CN & MN
|
|
Ohio
|
|
Yes
|
|
|
25 dates of service/year in non-hospital setting, 8 hours/month of psychological testing
|
Fee for service
|
CN
|
|
Oklahoma
|
|
No
|
|
|
|
|
|
|
Oregon
|
|
No
|
|
|
|
|
|
|
Pennsylvania
|
|
No
|
|
|
|
|
|
|
Rhode Island
|
|
No
|
|
|
|
|
|
|
South Carolina
|
|
No
|
|
|
|
|
|
|
South Dakota
|
|
Yes
|
$3/visit
|
|
40 hours therapy/year
|
Fee for service
|
CN
|
|
Tennessee
|
|
Yes
|
|
|
|
|
A & B - See state-specific FN
|
|
Texas
|
|
Yes
|
|
|
30 visits/year
|
Fee for service
|
CN & MN
|
|
Utah
|
|
Yes
|
|
|
Services limited by type and by beneficiary age and condition
|
Fee for service
|
A & B - See state-specific FN
|
|
Vermont
|
|
Yes
|
|
|
|
Fee for service
|
A & B - See state-specific FN
|
|
Virginia
|
|
Yes
|
|
After initial 26 visits
|
52 visits in year one and 26 visits in subsequent years
|
Fee for service
|
CN & MN
|
|
Washington
|
|
Yes
|
|
Yes
|
1 psychological evaluation/lifetime, 1 hour therapy/day up to 12 hours/year
|
Fee for service
|
CN
|
|
West Virginia
|
|
Yes
|
|
Yes
|
|
Fee for service
|
A & B
|
|
Wisconsin
|
|
No
|
|
|
|
|
|
|
Wyoming
|
|
Yes
|
$2/therapy service
|
|
|
Fee for service
|
CN
|
|
American Samoa
|
|
No
|
|
|
|
|
|
|
Guam
|
|
Yes
|
|
|
20 service sessions/year
|
Fee for service
|
CN
|
|
Northern Mariana Islands
|
|
No
|
|
|
|
|
|
|
Puerto Rico
|
|
Yes
|
|
|
Limited to services rendered by contracted staff
|
Fee for service or capitated payment
|
CN & MN
|
|
Virgin Islands
|
|
No
|
|
|
|
|
|
