TRICARE Rules
Regarding
Independent Practice
Answer to Question:
How does a licensed counselor qualify to provide counseling
services for the health care program serving uniformed service
members, retirees and their families--commonly known as TRICARE?
Rules regarding the
independent practice of licensed counselors providing services to
TRICARE beneficiaries (uniformed service members, retirees and their
families worldwide).
TRICARE is the name of the health care system
for service members and their dependents in the United
States Department of Defense Military Health System.
TRICARE was formerly known as the Civilian Health and
Medical Program of the Uniformed Services (CHAMPUS).
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1/04/12: The National Board for Certified Counselors, Inc. (NBCC)
is providing the following important alert regarding recent changes
released by the Department of Defense. The changes relate
specifically to the provision of mental health services to TRICARE
beneficiaries. TRICARE is the health care program serving uniformed
service members, retirees and their families worldwide.
NCCs following this
issue will recall that under previous TRICARE regulations, licensed
counselors were required to obtain a physician's referral and
supervision prior to providing mental health services to
beneficiaries. (For more information about the history of this
advocacy effort, please visit
http://www.nbcc.org/About/AdvocacyUpdates.)
On December 27, 2011,
the Department of Defense released the interim final rule
regarding the independent practice of licensed counselors providing
services to TRICARE beneficiaries. Briefly, this rule:
1. Creates a
new category of health professionals authorized to practice
independently under TRICARE. These professionals will be known
as certified mental health counselors (CMHCs).
(NOTE: This is not NBCC's voluntary credential, the certified
clinical mental health counselor (CCMHC).)
2. Identifies criteria for the identification of CMHCs.
3. Establishes a transition period from December 27, 2011,
to December 31, 2014.
Additional Details:
Licensed counselors who are recognized by the Department of Defense
as CMHCs will be allowed to practice autonomously (i.e., without a
physician's referral and supervision) and receive third-party
reimbursement.
During the transition
period from December 27, 2011, to December 31, 2014
• Licensed
counselors who do not meet the requirements for the newly
established category of CMHC may continue to provide services to
TRICARE beneficiaries under the previous requirement of physician
referral and supervision. (However, beginning January 1, 2015,
the Department of Defense will no longer recognize those counselors
who do not meet the criteria of CMHC, even with the referral and
supervision of a physician.)
• The criteria for
the CMHC include the following:
• Possession
of a state license for independent practice in mental health
counseling issued by the jurisdiction in which the individual is
practicing. In jurisdictions with two or more licenses allowing
for differing scopes of independent practice, the licensed
mental health counselor may only practice within the scope of
the license he or she possesses.
• Possession of a master's degree or higher from a mental
health counseling education and training program accredited by
the Council for Accreditation of Counseling and Related
Educational Programs (CACREP) and a passing score on the
National Counselor Examination for Licensure and Certification (NCE)
OR Possession of a master's degree or higher from a
mental health counseling education and training program that is
either CACREP accredited or from a regionally accredited
institution, and a passing score on the National Clinical Mental
Health Counseling Examination (NCMHCE).
• A minimum of two (2) years of post-master's degree
supervised mental health counseling practice that includes a
minimum of 3,000 hours of supervised clinical practice and 100
hours of face-to-face supervision. Required supervision must be
provided by a mental health counselor who is licensed for
independent practice in mental health counseling in the
jurisdiction in which he or she is practicing and must be
conducted in a manner that is consistent with the American
Mental Health Counselors Association (AMHCA) guidelines for
supervision. (see webmaster note, below.)
Beginning January 1,
2015
• Only those licensed counselors recognized as CMHCs
will be authorized to provide services to TRICARE beneficiaries.
• The criteria for the CMHC change to the following:
• Possession of a state license for independent practice in
mental health counseling issued by the jurisdiction in which the individual is practicing. In jurisdictions
with two or more licenses allowing for differing scopes of independent practice, the licensed mental health
counselor may only practice within the scope of the license he or she possesses.
• Possession of a master's degree or higher from a mental
health counseling education and training program accredited by the Council for Accreditation of Counseling
and Related Educational Programs (CACREP).
• A passing score on the National Clinical Mental Health
Counseling Examination (NCMHCE) or its successor as determined by TRICARE.
• A minimum of two (2) years of post-master's degree
supervised mental health counseling practice that includes a minimum of 3,000 hours of supervised clinical
practice and 100 hours of face-to-face supervision. Required supervision must be provided by a mental health
counselor who is licensed for independent practice in mental health counseling in the jurisdiction in which
he or she is practicing and must be conducted in a manner that is consistent with the American Mental Health
Counselors Association guidelines for supervision.
(see webmaster note, below.)
NBCC has created an expedited examination registration form for
counselors wishing to take the NCMHCE for the purpose of serving the military. Interested counselors can
download and submit the form posted on the NBCC Web site:
http://www.nbcc.org/Assets/RegistrationForm/NCMHCERegistrationForm.pdf
NBCC is creating a similar examination registration process for those
interested in taking the NCE during the transition period established by the Department of Defense. This
application should be available within the month.
To read the original release in the Federal Register, go to
http://www.federalregister.gov/articles/2011/12/27/2011-33109/tricare-certified-mental-health-counselors#p-3.
The Department of Defense is accepting comments on the regulations until February 27, 2012. NCCs seeking modifications
to the regulations are encouraged to submit comments to the Department of Defense. Specific information on submitting
comments is contained in the Federal Register.
Questions regarding registering for an NBCC examination should be directed to
examinations@nbcc.org.
NBCC, the American Counseling Association (ACA) and AMHCA have been
advocating on behalf of the counseling profession for years. NBCC is pleased with this most recent accomplishment
and will continue to advocate for the inclusion of qualified counselors.
Webmaster note RE: AMHCA Supervisor
Standards
“AMHCA recommends at least 24 continuing education hours or equivalent graduate credit hours of training in the theory and
practice of clinical supervision for those Clinical Mental Health Counselors who provide pre-degree or post degree clinical
supervision to CMHC students or trainees. AMHCA Recommends that Clinical Supervisors obtain, on the average, at least 3 continuing
education hours in supervision per year as part of their overall program of continuing education. Clinical supervisors should
meet the following knowledge and skills criteria.
Read complete supervisor requirements on pages 7 to 9, in a .pdf file titled, "STANDARDS for the Practice of Clinical Mental Health
Counseling."
