LA| Louisiana Department of Insurance Directive 229 requires all health insurance issuers, HMOs, and self-insured plans in Louisiana to provide nondiscriminatory, parity-compliant reimbursement to licensed medical psychologists for all covered mental health services within their scope of practice, including psychotherapy, medication management, ordering and interpreting labs, and prescribing permitted psychotropic medications, with reimbursement methodologies aligned to those used for other licensed prescribers and in compliance with federal provider nondiscrimination and mental health parity laws, using appropriate codes such as CPT 90863 for medication management in conjunction with psychotherapy.
Key Points:
- Insurers must reimburse medical psychologists for psychotherapy and medication management services (including CPT 90863 or appropriate E/M codes) on the same methodological basis as other prescribers performing the same services, and may not use coding or payment practices that result in lower reimbursement for mental health services or specific provider types.
- Federal law cited in the directive (42 U.S.C. 300gg-5 and 29 U.S.C. 1185a) prohibits discrimination against providers acting within their license and bars non-quantitative treatment limits that make mental health or substance use disorder coverage more restrictive than medical/surgical benefits.