Effects of Scope of Service and Reimbursement on Access to Mental Health Services in Rural Areas

Research center:
Lead researcher:
David Hartley, PhD, MHA, 207.780.4430
Project completed:
May 2002
Mental health professionals are differentially distributed in rural and urban areas, with psychiatrists and Ph.D. level psychologists tending to practice in urban and suburban areas, leaving mental health professionals with master's level preparation or less as the most readily available mental health providers in most rural areas. The availability of mental health services is further affected by scope of practice laws and reimbursement rules. Each state determines by statute what services can be provided by each of the five core mental health professions. Within the framework of state scope of practice laws, both public and private insurers have adopted a variety of rules regarding reimbursement for services provided by different types of mental health professionals. This study will investigate how scope of service and reimbursement policies affect the availability of mental health services in rural areas.

We will document which services are included in the scope of practice for each of the five core mental health professions in all states with substantial rural populations. For a subset of these states, we will document the geographic distribution of each of the five core mental health professions and determine which services Medicaid, Medicare and selected commercial insurers will reimburse for each.

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