Psychologists/Behavioral Health Billing Information

Licensed psychologists and licensed social workers are enrolled for services provided to QMB recipients or to recipients under the age of 21 referred as a result of an EPSDT screening. Licensed counselors and licensed marriage and family therapists are enrolled only for services provided to a recipient under the age of 21 as a result of an EPSDT screening.

• Behavioral Health  - Provider Manual Chapter 34 
• Administrative Code - Chapter 11
• Supervision Contract - Fillable
• Supervision Contract - Printable
• Psychologist Supervisor Contract_Termination - Fillable
• Psychologist Supervisor Contract_Termination - Printable
• Psychologist Supervision Contract Change of Address Form - Fillable
• Psychologist Supervision Contract Change of Address Form - Printable
• Diagnostic Intake Interview - Fillable - 10/16/19
• Diagnostic Intake Interview - Printable - 10/16/19
• Alabama Medicaid Psychology (AMP) Referral Form - Fillable - Revised
• Alabama Medicaid Psychology (AMP) Referral Form - Printable - Revised
• Completing Alabama Medicaid Psychology (AMP) Referral Form
• Request for Overrides of Weekly Visit Limitations Sample Cover Letter  
• Checklist for Psychologists - Information on denials, reasons for recoupments, where to find information in the Medicaid Provider Billing Manual, free tools and contacts for providers to use in preventing fraud and abuse.