Therapy practicum question

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Oct 15, 2023
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Hello all - I am a faculty member at an academic medical center that accepts 3rd year clinical psychology doctoral students for practicum. Currently, these students are participating in psychological and neuropsychological evaluations under my direct supervision. Since they are unlicensed, they are not practicing independently in patient care. Rather, I sit next to them while they administer tests I trained them on or I watch a livestream of their work towards the end of the practicum year.

Their university professor is asking for more therapy experiences rather than just assessment cases. Setting aside the fact that our center is primarily assessment, my understanding is that doctoral students cannot provide any billable services without direct presence of the billing provider (such as the provider credentialed with insurance in the same room as the student providing the therapy). I recall my own therapy practicum where I could only see pro bono cases that did not involve insurance. The academic medical center I work for has a financial assistance program for our patients, but there are no pro bono cases.

Please help with any information about practicum students and what they can do clinically. I'd like to provide these students with experiences in an area they are asking for, but I believe that there are no ways forward here.

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I believe it's going to depend on the individual insurance in question. Some will allow providing services by trainees and others will require that the supervisor be in the room.

If your center runs any groups, that might be one option, with the trainee as a co-facilitator.
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You are partially incorrect. You have to be in the office suite, NOT the office room.

According to 42 CFR 410.32, "Direct supervision in the office setting does not mean that the physician must be present in the same room with his or her aide. However, the physician must be present in the office suite and immediately available to provide assistance and direction throughout the time the aide is performing services."

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