Master’s Level Therapist (MLT) Pilot: History and Goals

Running from January 1, 2020 until January 1, 2024, the MLT pilot had two main goals:

1. Expand access to behavioral health interventions delivered by qualified MLTs. These behavioral health interventions are intended to better enable workers to heal and return to work, and aid attending providers to address barriers that impede recovery from work-related injury or illness.
2. Expand access to appropriate care for accepted mental health conditions delivered by qualified MLTs. While L&I’s current mental health system will remain unchanged, MLTs in the pilot will be able to provide care for accepted mental health conditions. If a mental health condition is contended by the attending provider, it will go through L&I’s current mental health evaluation and authorization process (MLTs are not allowed to diagnose mental health conditions or perform mental health evaluations in the pilot).

*MLTs include Licensed independent Clinical Social Workers (LICSWs), Licensed Marriage and Family Therapists (LMFTs), and Licensed Mental Health Counselors (LMHCs).

Eligible participating providers include:

• Licensed Independent Clinical Social Workers (LICSWs)
• Licensed Marriage and Family Therapists (LMFTs)
• Licensed Mental Health Counselors (LMHCs)

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.
  • Labor and Industries Master's Level Therapist Pilot Project Training
    
    • CE Test and Evaluation

Documentation & Payment Policy

For detailed information on payment policy, limits, and requirements, please refer to L&I's Medical Aid Rules and Fee Schedules (MARFS), including:

1. Read Chapters 1 and 2 of MARFS,
2. Read Chapter 17: Mental Health Services and Chapter 22: Other Services - Behavioral Health Interventions,
3. Our website on billing L&I, and consider signing up for a billing workshop.

Behavioral Health Services:

• Require a referral from the attending provider
• 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
• 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 per worker
    • Up to an additional 8 visits maximum may be allowed with
      prior authorization if the provider has demonstrated
      improvement 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:
    • The Patient Health Questionnaire 4 (PHQ-4)
    • Two-item Graded Chronic Pain Scale (2-item GCPS)

Mental Health Services:

• When referred for by the Attending Provider, a MLT provider may request authorization to provide appropriate psychotherapy treatment for an already accepted mental health condition on the claim, under L&I’s current mental health authorization process. Refer to Mental Health Services for more information.
  • An MLT may not diagnose a mental health condition or perform a mental health evaluation. If a mental health condition is contended, it would go through L&I’s current mental health evaluation and authorization process.

For information on Mental Health Services, including authorization and reporting requirements, please visit Mental Health Services.

Rules & Contacts

Contacts

MLT Pilot Information and Questions:

MLT@Lni.wa.gov

Billing and Payment questions:

Provider Hotline PHL@lni.wa.gov

Provider Account Questions PacMail@Lni.wa.gov

Automated Claim and Billing Information Line 1-800-831-5227

General Information for Providers in Medical Aid Rules and Fee Schedules

Rules and Laws

• Billing procedures: WAC 296-20-125
• No Balance Billing: WAC 296-20-020 and WAC 296-20-022 (2)
• Proper and necessary definition: WAC 296-20-01002
• Mental Health Providers: WAC 296-21-270