The Ohio scope of practice rules for mental health providers and counselors can pose staffing and billing issues for mental health professionals, particularly those who provide psychotherapy services.

Psychotherapy services in Ohio (including assessment, diagnosis, treatment and counseling) must be primarily performed by psychologists, social workers or psychology assistants under the supervision of a licensed psychologist. Under Ohio’s scope of practice rules, some psychotherapy services can be provided by social workers and psychology assistants without supervision, and independent social workers can even supervise some psychotherapy services. Unlicensed practice and improper billing issues arise if services are provided by, or supervised by unauthorized personnel.

In conjunction with the ramifications of unlicensed practice of psychotherapy, services provided in this manner cannot be billed to either Medicare or Medicaid. Additionally, if a program has been billing for services without the appropriate personnel providing or supervising them, it may have to repay all of the reimbursement for those services and is at risk of additional penalties.

Counseling services for mental and emotional disorders are also covered under Ohio’s scope of practice rules. The diagnosis and treatment of mental and emotional disorders may be performed by licensed counselors in the State of Ohio, but only licensed professional clinical counselors can diagnose mental and emotional disorders without the supervision of certain qualified mental health professionals. Additionally, counselors who are engaging in the diagnosis and treatment of mental and emotional disorders with supervision must disclose to their patients that they are working under the supervision of an appropriately licensed mental health professional. As with psychotherapy services, counseling services in Ohio may only be provided by the appropriate personnel or those services cannot be billed to Medicare or Medicaid, and any services that are improperly billed can lead to penalties including repayment.

To avoid unlicensed practice and improper billing issues, mental health providers should ensure they are practicing within their scope of practice permitted under Ohio law and that supervision is being provided when required.