Professionals in training must be working towards and participating in a supervision plan to become a recognized, payable provider by Blue Cross Blue Shield of North Dakota (BCBSND). These professionals must practice under the direct supervision of a provider, as approved by the individual’s board who is licensed, registered, or certified by the appropriate state agency and meets the credentialing criteria set forth by BCBSND. Direct supervision means the supervising provider must be present in the office suite and/or on a telehealth visit and immediately available to provide assistance or direction to the professional in training. Services must be billed using the supervising provider’s NPI and appropriate modifier when applicable.
To identify professionals in training who are eligible and must bill under the supervising provider’s NPI.
Professionals in training who are eligible and must bill under the supervising provider’s NPI.
- Licensed Associate Professional Counselor (LAPC)
- Licensed Associate Marriage Family Therapist (LAMFT)
- Graduate Registered Nurse Anesthetists (GRNA)
- Post-doctoral Psychology Resident
- Psychiatry Resident in psychotherapy training under the direct supervision of a psychologist
- Resident Psychiatric Physicians in their 2nd year of training or greater that have met the specific supervision standards through their accrediting body
Professionals in training who are not eligible to bill.
- Resident Physicians
- The attending/supervising physician must either be present while the substantial elements of the history and examination are performed by the resident, or the attending/supervising physician must independently perform them. Billing occurs under the attending/supervising physician’s NPI.
- The attending/supervising physician participates in the clinical decision making and formulation of the treatment plan.
- Documentation by the attending/supervising physician needs to support this information.
The information in this article will be placed within the next 30 days in both our BCBSND and ND Medicaid Expansion provider manuals.
For additional questions, contact the appropriate Customer Contact Center.
- BCBSND: 1-800-368-2312
BCBSND Medicaid Expansion: 1-833-877-5779