Behavioral health interventions are brief courses of care with a focus on the worker's ability to return to work by addressing psychosocial barriers that impede their recovery.
These psychosocial barriers are not components of a diagnosed mental health condition; instead, they are typically a natural reaction to an injury, or personal complicating factors. Because they arise from and are related to recovery of a physical injury, they are billed under the physical injury diagnosis of the accepted condition. Common barriers are impaired recovery expectations, catastrophic thinking, and fear avoidance behavior. To learn more, refer to Psychosocial Barriers Influencing Recovery.
Intervention can take many forms. Cognitive behavioral therapy, problem solving therapy, and motivational interviewing are popular methods.
Behavioral health interventions are appropriate if the provider has reason to believe that psychosocial factors, difficulty coping, or additional barriers may be affecting the worker’s medical treatment and management of an injury, or affecting their return to work efforts. It is important to note that these services are not a replacement for mental health services. If there is suspected mental health, please refer to our mental health services resource.
Providers offering BHI services may be found by going to Find a Doctor.
- Search your local area using the "all providers" category.
- Choose psychologists and MLT under the "behavioral or mental health care" specialty.
Eligible participating providers include:
- Licensed Independent Clinical Social Workers (LICSWs)
- Licensed Marriage and Family Therapists (LMFTs)
- Licensed Mental Health Counselors (LMHCs)
- Clinical Psychologists (PhD, PsyD)
How to become an L&I Provider:
- Complete a ProviderOne Application (Refer here for details and guides)
- All providers new to L&I and ProviderOne must apply for an L&I account through ProviderOne
- Additionally, L&I offers a helpful training module for providers who may be new to workers' compensation. Completion of the training module is highly recommended.
Provider Account Questions PacMail@Lni.wa.gov
Behavioral Health Services Are a brief course of care with a focus on addressing psychosocial barriers that impede a worker’s recovery and improve their ability to return to work.
- Require a referral from the attending provider
- Are billed under the approved physical diagnosis
- Do not require prior authorization
- Utilize CPT© codes 96156, 96158, and 96159
- No more than one hour may be billed on a single date of service/visit.
- 16 visits limit for the life of the claim
- Up to an additional 8 visits may be allowed with prior authorization if the provider has demonstrated clinically meaningful improvement in function through prior treatment and established sufficient medical necessity to the insurer in advance of the additional visits.
- Documentation using L&I’s Behavioral Health Interventions form are required to show progress and improvement in function throughout visits.
Behavioral Health Interventions Form - Required psychometric measures listed on the form includes:
For more information on billing, visit our billing website or sign up for a workshop.
| Provider Type | Requirements | Coverage Policies |
| Psychologists | Requires AP referral No prior authorization required |
Chapter 17 MARFS |
| Master’s Level Therapists (MLTs) | Requires AP referral No prior authorization required |
Chapter 17 MARFS |
| Attending Provider (AP) | Bundled with E/M codes, not separately billed | Chapter 3 MARFS |
Note: Behavioral health interventions aren’t covered if a diagnosed mental health condition has been accepted or denied by order on a claim.
For information on Mental Health Services, including authorization and reporting requirements, please visit Mental Health Services and Chapter 17 of MARFS for details on treating mental health conditions.
Here are a selection of resources and more information on behavioral health services and how they can influence a worker's recovery:
- Educational resources for attending providers to learn more about identifying, recognizing, and addressing Psychosocial Determinants Influencing Recovery
- Activity Coaching is appropriate for workers who have not returned to work or not to their usual hours, and need a structured reactivation program to address psychosocial barriers impacting their recovery.