The Master’s Level Therapist (MLT) Pilot has two goals:

1. Expand access to behavioral health interventions delivered by qualified MLTs. These behavioral health interventions are intended to better enable workers to heal and return to work, and aid attending providers to address barriers that impede recovery from work-related injury or illness.
2. Expand access to appropriate care for accepted mental health conditions delivered by qualified MLTs. While L&I’s current mental health system will remain unchanged, MLTs in the pilot will be able to provide care for accepted mental health conditions. If a mental health condition is contended by the attending provider, it will go through L&I’s current mental health evaluation and authorization process (MLTs are not allowed to diagnose mental health conditions or perform mental health evaluations in the pilot).

*MLTs include Licensed independent Clinical Social Workers (LICSWs), Licensed Marriage and Family Therapists (LMFTs), and Licensed Mental Health Counselors (LMHCs).

Project Participation

Up to 300 MLTs may be enrolled initially, with provisions made to achieve equitable provider distribution, by county, throughout the state of Washington.

Qualified participating providers include:

• Licensed Independent Clinical Social Workers (LICSWs)
• Licensed Marriage and Family Therapists (LMFTs)
• Licensed Mental Health Counselors (LMHCs)

Enrollment has begun as of November 15, 2019. Relevant pilot information and specific pilot dates will be posted on this webpage and sent out via the "Master's Level Therapist Updates" E-Gov Bulletin.

How to apply to participate:

Complete and submit all of the following:

• L&I required training module completion certificate (signed and dated)
  • Please note, creation of a Secure Access Washington (SAW) account is required to complete the training.
    1. Create a SAW account (if you already have one, use that)
    2. Select “Add a New Service” when logged in to your SAW account
    3. Select "Department of Labor and Industries" from the list of agencies
    4. Select “My L&I”
    5. Refer to these instructions from here
  • You must print/screenshot, and sign and submit, the training completion certificate with your application.
• MLT Pilot supplemental application
• Complete a ProviderOne Application (Refer here for details and guides)
  • All providers new to L&I and ProviderOne must apply for an L&I account through ProviderOne

Documentation & Payment Policy

For detailed information on payment policy, limits, and requirements, please review this document: L&I MLT Pilot Payment Policy.

*PLEASE NOTE: EFFECTIVE January 10, 2022 Utilization Review is no longer required for MLT behavioral health visits. No prior authorization for MLT visits is required for up to 16 visits per claim. You do not need to submit a prior authorization request for MLT visits. Also, remember, there is a 16 visit limit per claim. If you have questions, please contact MLT@Lni.wa.gov.

Behavioral Health Services in the pilot:

• Require a referral from the attending provider
• Are a brief course of care with a focus on addressing psychosocial barriers that impede a worker’s recovery and improve their ability to return to work
• Do not require prior authorization 
  • Utilize CPT^© codes 96156, 96158, and 96159
  • No more than one hour may be billed on a single date of service/visit.
  • A maximum of 16 visits per claim
• Documentation using L&I’s MLT pilot forms is required to show progress and improvement in function throughout visits. 
  • MLT Pilot Behavioral Health Assessment Form
    • To be used at the initial visit
  • MLT Pilot Behavioral Health Intervention/Re-assessment Form
    
    • Intervention/treatment summary to be used at each follow-up visit
    • Re-assessment to be used when there are flare-ups
  • Required psychometric measures listed on these forms include:
    • The Patient Health Questionnaire 4 (PHQ-4)
    • Two-item Graded Chronic Pain Scale (2-item GCPS)
• For further detailed information, refer to the Frequently Asked Questions document

Mental Health Services in the pilot:

• When referred for by the Attending Provider, a MLT pilot provider may request authorization to provide appropriate psychotherapy treatment for an already accepted mental health condition on the claim, under L&I’s current mental health authorization process. Refer to Mental Health Services for more information.
  • An MLT may not diagnose a mental health condition or perform a mental health evaluation. If a mental health condition is contended, it would go through L&I’s current mental health evaluation and authorization process.

For information on Mental Health Services, including authorization and reporting requirements, please visit Mental Health Services.

Rules & Contacts

UPDATE August 2023:

A Virtual Public Hearing is scheduled for September 7th, 2023 at 9:00am to solicit comments on proposed rulemaking related to the MLT pilot. All testimony and written comments become part of the public record. The proposed rule is scheduled for adoption on October 31, 2023, with a scheduled effective date of January 1, 2024. More information can be found here: Rulemaking Activity at L&I (wa.gov)

The start date of treatment in the Master’s Level Therapist (MLT) Pilot is January 1, 2020

MLTs able to enroll in the pilot include Licensed Independent Clinical Social Workers (LICSWs), Licensed Marriage and Family Therapists (LMFTs), and Licensed Mental Health Counselors (LMHCs). Providers enrolled and accepted by Labor & Industries (L&I) in the pilot can begin treating under the terms and conditions of the pilot on January 1, 2020 after the CR-101 is filed or as otherwise specified by L&I. During this time, only providers approved to participate in the pilot will be able to provide treatment.

The MLT pilot will last for up to four years, or until sufficient data is gathered to assess and evaluate the provision of treatment by MLTs within the workers' compensation setting.

During the course of the MLT pilot, L&I will evaluate and consider pilot metrics, data, and experiences.

Update July 2023 - Survey of provider and patient experiences

• Survey without Appendices
• Appendices

The CR-102 will be filed when there is sufficient data collected to assess and evaluate the provision of treatment by MLTs within the workers’ compensation setting. After the CR-102 is filed only providers participating in the pilot can continue to provide services to workers.

The CR-103 adopts the final changes to the affected rule and is usually effective 31 days after the filing date. Once the CR-103 is filed and effective, any providers that meet and comply with all the criteria detailed in the resulting rule, coverage decision, and/or payment policy can enroll with L&I to provide treatment to workers.

Contacts

MLT Pilot Information and Questions:

MLT@Lni.wa.gov

Billing and Payment questions:

Provider Hotline 800-848-0811

General Information for Providers in Medical Aid Rules and Fee Schedules

Rules and Laws

• Billing procedures: WAC 296-20-125
• No Balance Billing: WAC 296-20-020 and WAC 296-20-022 (2)
• Proper and necessary definition: WAC 296-20-01002
• Pilot Rulemaking: RCW 34.05.313
• Current L&I rules regarding MLTs: WAC 296-21-270