Credentialing in Alabama

Alabama Medicaid is administered by the Alabama Medicaid Agency, with provider enrollment through its Provider Enrollment portal (medicaidhcp.alabamaservices.org, Gainwell fiscal agent). Enrollment grants a provider the right to bill the Alabama Medicaid Agency for fee-for-service claims. Since Alabama has no capitated MCOs, enrollment is with the state and claims are FFS through the central fiscal agent, with no separate MCO credentialing layer for most services.

Alabama Medicaid Agency (medicaid.alabama.gov) via kb/states/al.md · checked Jul 2026

None (capitated). Alabama never adopted risk-based Medicaid MCOs; it runs the Alabama Coordinated Health Network (ACHN), a non-capitated regional care-coordination program under a 1915(b) waiver across seven regions. Per the agency, "delivery of medical services is not part of this program." ACHN holds no insurance risk, pays no claims and builds no closed network: all billing stays fee-for-service through the state's fiscal agent, so there is no MCO to get in-network with.

Alabama Medicaid Agency, ACHN Managed Care page via kb/states/al.md · checked Jul 2026

An Associate Licensed Counselor (ALC) enrolls directly with Alabama Medicaid (provider type 07, specialty 071) and bills under their own NPI at 75% of the allowable amount, but only for recipients under age 21 referred through an EPSDT screening; Alabama is not an adult-outpatient associate-billing state. LMFTA (075) and LMSW (073) are also enrollable specialties, covered treatment diagnoses are limited to ICD-10 F0150-F069 and F080-F099, and since 2025 LPCs/ALCs and LMFTs no longer require psychologist signatures on treatment documents.

Alabama Medicaid Provider Manual Ch. 34 (Apr 2026) via kb/states/al.md · checked Jul 2026

Three separate boards license Alabama BH clinicians: the Alabama Board of Examiners in Counseling (ABEC; ALC advancing to LPC, admin code 255-X), the Alabama State Board of Social Work Examiners (LBSW/LMSW/LICSW/PIP), and the Alabama Board of Examiners in Marriage & Family Therapy (admin code 536-X).

Alabama Board of Examiners in Counseling via kb/states/al.md · checked Jul 2026

Alabama is a Counseling Compact member (an early adopter. Enacted 2022, on the counselingcompact.gov jurisdictions list) but was not yet issuing compact privileges as of July 2026; issuing states at that point were AZ, MN, OH, LA, GA and IN.

Counseling Compact, Compact Jurisdictions list via kb/states/al.md · checked Jul 2026

Alabama Medicaid behavioral health is fee-for-service with two doors: Rehab-Option services delivered by entities certified by the Alabama Department of Mental Health (ADMH), and licensed practitioners (LPC, LMFT, LICSW, plus ALCs) enrolling under Ala. Admin. Code r. 560-X-11-.14 "EPSDT Referred Service Providers", a population/referral-restricted pathway (QMB recipients, EPSDT-screening-referred, or the psychologist-referral cascade), not wide-open independent billing.

Ala. Admin. Code r. 560-X-11-.14 (Cornell LII) via kb/states/al.md · checked Jul 2026