Michigan Mental Health Counselors Association

Michigan Mental Health Counselors Association Licensed Professional Counselors are educated, trained, and licensed to promote mental health and to

Provide a system of Information exchange among mental health counselors through networking, a website, online newsletter, and educational and professional development meetings.

11/13/2025

**IMPORTANT UPDATE: Medicare Telehealth Flexibilities Restored**

Michigan mental health counselors, we have good news to share.

As many of you know, during the recent government shutdown (October 1 - November 12, 2025), Medicare telehealth flexibilities lapsed. During that period, we advised members that in-person visits were required for Medicare patients receiving behavioral health services via telehealth.

**The situation has changed.**

On November 12, 2025, President Trump signed H.R. 5371 into law, which **reinstates Medicare telehealth flexibilities through January 30, 2026**. This means:

- You can resume providing telehealth services to Medicare patients from their homes
- The 6-month initial in-person visit requirement for new patients is waived through January 30, 2026
- The 12-month in-person visit requirement for existing patients is waived through January 30, 2026
- Audio-only services remain available for behavioral health when appropriate
- Claims submitted during the shutdown period (October 1 - November 12) will be processed retroactively

**What you need to know:**

This is a temporary extension. Without further congressional action, these flexibilities will expire again on January 31, 2026, and the in-person visit requirements would return.

Multiple bills are currently in Congress seeking to make these flexibilities permanent, including the bipartisan CONNECT for Health Act (H.R. 4206/S. 1261), which would permanently eliminate the in-person visit requirements for behavioral health telehealth services.

We will continue monitoring the situation closely and provide updates as Congress considers longer-term or permanent solutions.

**For now, you may continue providing Medicare telehealth services as you did before October 1, 2025.**

Questions? Please reach out to MMHCA leadership

Sincerely,

Your MMHCA Board - Supporting Michigan’s LPCs Providing Mental Health Counseling

11/12/2025

Legislation Update:

House Health Policy voted out HB 4981 (restoring LLPC designation) today with unanimous support (14 Yeas, 0 Nays). The bill has now been referred to the House Rules Committee, which has been the standard procedure this session. Our lobbyist will be meeting with the Chair of the House Rules Committee later this week to discuss the timeline for a committee hearing. What should follow is an initial hearing with brief testimony, followed by a second hearing for a vote to move the bill to the House floor. Thank you to Rep. Fairbairn for moving this legislation forward.

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11/07/2025

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We’re looking for individuals to pilot the new Spanish language version of the National Counselor Examination (NCE). You’ll receive a free score report to send to your state licensure board. Examinations will be administered in January, and scores will be provided by March. Anyone who is interested should email certification@nbcc.org before Nov. 20, 2025.

Below is MMHCA Board Secretary Carol Berger's testimony before the Michigan House Health Policy Committee on November 5,...
11/07/2025

Below is MMHCA Board Secretary Carol Berger's testimony before the Michigan House Health Policy Committee on November 5, 2025.

MMHCA Board Secretary Carol Berger, LPC testifies before the House Health Policy Committee on House Bill 4981 which would restore the title Limited Licensed ...

Michigan LPCs: Confused about Medicare? Do you really have to opt in or opt out of Medicare, or is there another option?...
11/06/2025

Michigan LPCs: Confused about Medicare? Do you really have to opt in or opt out of Medicare, or is there another option?

As of January 1, 2024, fully licensed Michigan LPCs are recognized as Medicare providers under the Mental Health Access Improvement Act, but many counselors don’t realize there’s a third choice: enrolling as a non-participating provider with flexible claim options.

MMHCA has just released a complete, plain-language guide to help you understand all three paths (participating, non-participating, and opt-out) with examples, compliance steps, and Michigan-specific details.

Learn which option fits your practice best, avoid costly compliance mistakes, and stay connected to expert support through MMHCA’s monthly Medicare Q&A sessions with Dr. Elizabeth Teklinski.

Read the full guide here: https://www.mmhcanow.org/medicareqanda

Upcoming Member Event

Tuesday, November 18, 2025 | 12:00–12:45 PM
Ask Me Anything: Medicare & Private Practice Billing with Dr. Elizabeth Teklinski

Get expert answers to your questions about Medicare enrollment, incident-to billing, EMDR 90837 CPT code use, documentation requirements, Medigap, Medicare Advantage, and starting a private practice.

MMHCA Members Only
➡️ Register here: https://us02web.zoom.us/meeting/register/-m1EDaBWR_K8JrXfuhfq9A?utm_source=sendfox&utm_medium=email&utm_campaign=november-2025-member-events-llpc-update #/registration

Not a member? Join MMHCA today to attend and gain access to all future workshops, policy updates, and Q&A sessions:
➡️ Join here: https://michiganmentalhealthcounselorsassociation.app.neoncrm.com/forms/newmembership

11/05/2025

Below is testimony that was given before the Michigan House Health Policy Committee today, November 5, 2025:

TESTIMONY IN SUPPORT OF HB 4981 RESTORING THE
"LIMITED LICENSED PROFESSIONAL COUNSELOR" DESIGNATION

Michigan Mental Health Counselors Association

Honorable Committee Members,
I am Carol Berger, Secretary of the Michigan Mental Health Counselors Association, and I am here today to respectfully request your support in restoring the professional designation "Limited Licensed Professional Counselor" (LLPC) in Michigan's counselor licensing law.

The Problem
In 2019, when Michigan passed Public Act 96 of 2019, the legislation inadvertently changed the long-standing term "Limited Licensed Professional Counselor" (LLPC) to "Limited Licensed Counselor" (LLC). While this may seem like a minor change, it has created significant and ongoing confusion in our field.

For nearly three decades—from 1990 to 2019—Michigan used the LLPC designation. The change to LLC was not intentional; it was an oversight that has had unintended consequences.

Why This Matters
The abbreviation "LLC" is universally recognized as "Limited Liability Corporation" in business and legal contexts. When our counselors use "LLC" after their names, it creates confusion among:
• Clients seeking mental health services
• Insurance companies processing claims
• Other healthcare providers making referrals
• Professional credentialing bodies
• The general public

Additionally, Michigan now stands alone in using the LLC terminology. Most of the country recognizes and uses "LLPC" for this level of professional counselor licensing. This inconsistency creates unnecessary barriers for counselors who are licensed in multiple states and adds confusion to interstate professional recognition.

Our Request
We respectfully ask this committee to support HB 4981, which would restore the "Limited Licensed Professional Counselor" (LLPC) designation. This change would:
• Eliminate confusion with business entities
• Align Michigan with national standards
• Restore clarity to professional credentials
• Honor the nearly 30-year tradition that existed before 2019

This is a simple technical correction that will have a meaningful impact for Michigan's mental health counselors and the clients they serve.

Thank you for your consideration and for your continued support of mental health services in Michigan. I welcome any questions you may have.

Respectfully submitted,

Carol Berger, Secretary
Michigan Mental Health Counselors Association

Reminder, MMHCA MembersMedicare Consultation Group with Dr. Elizabeth TeklinskiThursday, October 30, 2025 |  12:00 PM ES...
10/30/2025

Reminder, MMHCA Members

Medicare Consultation Group with Dr. Elizabeth Teklinski

Thursday, October 30, 2025 | 12:00 PM EST
Open to MMHCA Members
Register here ➡️ https://us02web.zoom.us/meeting/register/-m1EDaBWR_K8JrXfuhfq9A?utm_source=sendfox&utm_medium=email&utm_campaign=october-2025-member-events #/registration

Join MMHCA Board Member Dr. Elizabeth Teklinski, author of Medicare Post 2025: The Mental Health Counselor’s Comprehensive Manual to Incident-To Billing, for our monthly Medicare Q&A session!

Each month, we unpack new Medicare updates, compliance strategies, and documentation best practices to help Michigan LPCs navigate the ever-changing billing and policy landscape with confidence.

Here is tomorrow's Session Guide: https://www.mmhcanow.org/medicareqanda

Important Question for Discussion:
Should we expand our monthly MMHCA Q&A sessions to include Private Practice Development topics?

Potential topics:
✓ Marketing Strategies – Building your brand, digital presence, and referral networks
✓ Licensure & Credentialing – Medicare enrollment, insurance panels, CAQH
✓ Billing & Revenue – Fee setting, insurance billing, cash models
✓ Business Operations – EHR selection, practice management, HIPAA compliance
✓ Growth & Sustainability – Scaling your practice, hiring, and work-life balance

We’d love your input!
Share your thoughts at MMHCABoard@MMHCAnow.org

This page accompanies MMHCA’s monthly Medicare Q&A sessions with Dr. Elizabeth Teklinski, MMHCA Board Member and author of Medicare Post 2025: The Mental Health Counselor’s Comprehensive Manual to Incident-To Billing. Each session provides real-time guidance, policy updates, and compliance strat...

Your Voice in Lansing: How Professional Advocacy Protects Michigan CounselorsDid you know MMHCA invests your membership ...
10/01/2025

Your Voice in Lansing: How Professional Advocacy Protects Michigan Counselors

Did you know MMHCA invests your membership dues in professional lobbying? Since 2018, our partnership with Acuitas has been the difference between having a seat at the table and watching from the sidelines when critical decisions about mental health policy are made.

Remember 2019? When regulatory challenges threatened our ability to diagnose and treat, MMHCA and Acuitas mobilized quickly. The result: HB 4325 became law, protecting the scope of practice for all 9,323 Michigan LPCs.

Today, our legislative team continues fighting for you:
Jane Diegel brings nearly a decade of government relations experience and healthcare policy expertise from her time at Forbes Tate Partners in DC. She's monitoring HB 4591 (Counseling Compact) daily.

Martin Johnston, former Chief of Staff to State Senator Roger Victory, uses his deep legislative connections to advocate for increased Medicaid rates and protect against insurance clawbacks that threaten practice stability.
Current priorities include:

Counseling Compact (HB 4591) - advocating for sunset provisions and insurance parity

Insurance clawback limits - protecting your financial stability
Medicaid reimbursement increases - recognizing the true value of mental health services

Telehealth modernization - protecting Michigan practices from out-of-state corporate dominance

Legislative processes are complex. Relationships matter. Timing is critical. Without professional representation, decisions affecting your practice would be made without your input.
Your membership makes this advocacy possible. Join us in protecting and advancing the counseling profession in Michigan.

Learn more at

https://www.mmhcanow.org/

Join MMHCA and Have Your Voice Heard in Lansing:https://michiganmentalhealthcounselorsassociation.app.neoncrm.com/forms/newmembership

The Medicare Telehealth In-Person RequirementThe waiver of the in-person visit requirement for Medicare behavioral/menta...
09/30/2025

The Medicare Telehealth In-Person Requirement

The waiver of the in-person visit requirement for Medicare behavioral/mental health telehealth services was only extended through today, September 30, 2025. This means that starting tomorrow, October 1, 2025, the pre-COVID requirement returns unless Congress acts.

What the Requirement Means

Beginning October 1, 2025, patients must have received a Medicare-covered mental health service in-person from the telehealth provider within six months prior to the first telehealth mental health service and then at least once every 12 months thereafter.

Specifically:
**New patients**: Would need an in-person visit within 6 months before starting telehealth mental health services
- **Existing patients**: Would need at least one in-person visit every 12 months to continue telehealth services

Exceptions

If the patient and provider agree that an in-person visit would cause more harm or burden than benefit (e.g., due to health risks or travel difficulties), they can skip it for that year — but the provider must document the reason in the patient's medical record.

Current Status

So far, Congress has not yet acted to extend this waiver beyond September 30, 2025. While there is broad bipartisan support for telehealth access and advocacy groups are pressing for action, it appears unlikely that Congress will enact a permanent solution at this time; however, they may include another short-term delay in a budget bill or a healthcare extenders package.

Impact on LPCs and Mental Health Counselors

This affects all Medicare providers offering mental health services via telehealth, including the newly eligible LPCs and LMFTs who just gained Medicare billing privileges in January 2024. We will now need to ensure our Medicare patients meet these in-person requirements to continue providing telehealth services.

Many providers and patients may not be fully aware of this change, and preparation is recommended, including notifying patients in advance about potential changes to telehealth eligibility.

This is indeed a significant "telehealth cliff" that could disrupt care for many Medicare beneficiaries receiving mental health services remotely, especially those in rural areas or with mobility challenges who have been relying on telehealth access since the pandemic.

Please share and post your questions below in the comments, and we will do our best to answer every one of them. Thank you!

09/09/2025

✯COUNSELING COMPACT UPDATE✯

Dear MMHCA Members and Michigan Counselors,

A bill to adopt the Counseling Compact was introduced and passed last week by the House Health Policy Committee of the legislature. The bill now moves on to the House Rules Committee.

The following is the Resolution our Board of Directors prepared and presented to the Health Policy Committee and the bill's sponsors:

✯MICHIGAN MENTAL HEALTH COUNSELORS ASSOCIATION BOARD RESOLUTION✯

✯Supporting Counseling Compact with Protective Safeguards✯

WHEREAS, the Michigan Mental Health Counselors Association (MMHCA) represents the professional interests of Licensed Professional Counselors (LPCs) throughout the state of Michigan; and

WHEREAS, MMHCA conducted a survey of over 12,000 counselors across Michigan, including MMHCA members, to assess attitudes and beliefs about the Counseling Compact; and

WHEREAS, approximately 60% of respondents (both members and non-members) supported implementation of the Counseling Compact, citing potential benefits including:

Enhanced professional mobility and multi-state Privilege to Practice opportunities
-Improved continuity of care for clients who relocate or travel
-Increased access to mental health services in underserved areas
-Expanded career opportunities for Michigan counselors; and

WHEREAS, approximately 30% of respondents expressed concerns about the Counseling Compact, primarily related to:

-Potential market saturation by large national telehealth providers (e.g., BetterHelp, Headway)
-Potential negative impact on private practice sustainability
-Potential for insurance reimbursement rate decreases if market becomes saturated with Counselors
-Unknown regulatory requirements and implementation details; and

WHEREAS, MMHCA recognizes both the significant opportunities and legitimate concerns expressed by our membership and counselors across Michigan; and

WHEREAS, Michigan counselors can potentially benefit from professional portability while maintaining protections for local practice sustainability, client welfare, and market stability within the framework of Compact requirements;

NOW, THEREFORE, BE IT RESOLVED that the Michigan Mental Health Counselors Association Board of Directors:

1. SUPPORTS the passage of Counseling Compact legislation in Michigan with the addition of the safeguards listed below (2 though 5)

Based on the clear majority support from our membership and counselors across the state, and the demonstrated benefits for professional mobility and client access to care, and taking into consideration potential negative impacts of the Counseling Compact.

2. STRONGLY RECOMMENDS the inclusion of protective safeguards in Michigan's Counseling Compact legislation, including:

A. Sunset Provision

-Implementation of a three-year sunset clause requiring legislative review and reauthorization
-Mandatory assessment of the Compact's impact on Michigan counselors and clients before renewal
-Data collection requirements on market effects, reimbursement rate changes, and practice sustainability

B. Market Protection Measures

-Establishment of monitoring mechanisms to track the impact of multi-state corporate providers on local practices
-Requirements for transparency in corporate counseling platform operations within Michigan
-Preservation of Michigan's right to establish additional consumer protection standards

3. COMMITS to ongoing advocacy efforts to:

-Work with state legislators to incorporate these protective measures into Michigan's Counseling Compact sunset legislation
Monitor implementation and impact on Michigan counselors and clients
-Provide regular updates and education to membership about Compact developments
-Advocate for insurance companies to honor Compact privileges and maintain fair reimbursement rates

4. ESTABLISHMENT of a Counseling Compact Monitoring Committee to:

-Track the effects of the Compact on Michigan's counseling workforce with support from the state
-Collect annual data on member experiences with multi-state practice
-Prepare recommendations for the three-year legislative review
-Serve as a resource for members navigating Compact participation
-Members of this committee will include LPCs, LARA personnel and representatives designated by the legislature

5. REAFFIRMS our commitment to:

-Supporting the professional growth and mobility of Michigan counselors
-Protecting the sustainability of private practice and independent counselors
-Ensuring high-quality mental health care for all Michigan residents
-Maintaining the integrity and standards of the counseling profession

Implementation Timeline

This resolution shall take effect immediately, with MMHCA directed to begin legislative advocacy efforts.

ADOPTED this 22nd day of August, 2025, by the Board of Directors of the Michigan Mental Health Counselors Association.

Chris DeBoer, MMHCA Board President

For more information on the Counseling Compact, please see counselingcompact.org

If you have questions please email us at MMHCABOARD@MMHCANOW.ORG.

Thank you very much!! Please consider joining our organization at mmhcaNOW.org. Having a robust membership allows us to continue the important work we are doing for the profession and continue funding our vital lobbyists.

In Service,

MMHCA’s Volunteer Board of Directors

Christopher DeBoer, President
Krystin Sankey, Treasurer
Carol Berger, Secretary
Members at Large:
Dr. Stephanie Burns
Dr. Joy Creel
David Flowers
Dr. Katherine James
Dr. Larry Pfaff
Lauri Rowe
Amy Szaraz
Dr. Elizabeth Teklinski
Steve Wheeler

Medicare Telehealth Update for Michigan LPCsMedicare telehealth rules are about to change, and it’s important every coun...
08/29/2025

Medicare Telehealth Update for Michigan LPCs

Medicare telehealth rules are about to change, and it’s important every counselor knows the timeline.

Through September 30, 2025: All Medicare telehealth services remain fully flexible. You can see clients from any location, including their homes. No in-person visit requirement yet.

October 1, 2025 forward: The in-person requirement for mental health telehealth begins. To continue telehealth services, clients must have had one in-person visit within the prior 6 months, then at least once every 12 months.

Good news: Mental health telehealth itself is permanent with no rural restrictions. Audio-only therapy is also allowed when video isn’t feasible (modifier 93).

General medical telehealth will revert to rural-only restrictions starting October 1.

Will Congress keep it the way it is now?

There’s strong bipartisan support and several bills in play (like the CONNECT for Health Act of 2025) that aim to permanently remove restrictions. National advocacy groups (AMA, ATA, CMA, etc.) are pushing hard for stability. That said, Congress has only passed short-term extensions so far, and the current deadline is firm at September 30, 2025. Another extension is possible, but not guaranteed.

From yesterday's MMHCA Medicare Q&A Guide We Shared
:
Plan now for the October 1 in-person requirement. Keep seeing clients via telehealth under the current rules through September. And stay engaged! Congress may extend flexibilities again, but until that happens, we should prepare as if the October change will take effect.

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PO Box 1541, Owosso
Rochester, MI
48867

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MMHCA led the way with you to pass HB4325/PA96. Unite with us as the protectors of our profession. MMHCA is your #1 Advocate!

The LPC Michigan Miracle of 2019. How MMHCA made it happen!

By James Blundo, MA, LPC, MMHCA Executive Director

Michigan has a new law that protects and strengthens our LPC license.

House Bill 4325 passed both the Michigan House and Senate by 100% of the legislators and was signed into law by the Governor on October 29th as Public Act 96 of 2019.