Medicaid has paid for psychotherapy for over 30 years, long before mental health professionals were licensed in Wisconsin. So Medicaid created a credential, Approved Provider, to identify those who could be providers of reimbursed services. The purpose of the credential was to identify persons who had met a minimum level of presumed competence. That credential is the well-known “3000-hour letter” formerly called the “Dan Crossman letter,” then when he retired, the “Otis Woods letter,” and more recently the “Mark Hale letter.”
Psychologists have been licensed since around 1977 and approved for insurance payments since around 1978.
In the early 1990s, a law was passed creating certification of Marriage and Family Therapists, Social Workers and Clinical Social Workers, and Professional Counselors. Certification only meant that no one could use those titles unless they met certain minimum requirements and were approved by the Department of Regulation and Licensing.
A law passed in 2001 upgraded certification to licensure. That meant not only were the titles protected, but the very practice of psychotherapy was limited to those with one of these licenses.
All along, graduate students could practice under Medicaid and bill under a supervisor.
All this time, around 34 years, those who had graduated with a masters or doctorate, but who had not completed the Approved Provider credential or, after 1993, certification, could not practice under Medicaid – their services could not be billed to Medicaid. This gap left new Masters level clinicians scrambling to get 3000 hours.
Finally, this week, Medicaid issued a bulletin, 2012-64, rectifying this long-standing problem. From now on, masters-level clinicians who procure a training license and PhD/PsyD level clinicians who are on post-doctoral training will be able to credential as Medicaid providers. They will be known as Qualified Treatment Trainees (QTT), a title defined under DHS35.03. These provisions ONLY apply when the clinician works for a licensed mental health clinic.
This a major step to enable clinicians to train for licensure and to increase the capacity of the mental health community to serve Medicaid clientele.