“Why can’t the therapist I want to see take my insurance?”
It’s a fair question. If you have insurance coverage and you’re seeking care, it seems reasonable to expect that you should be able to use your benefits with the provider you choose.
Unfortunately, the answer is often much more complicated than most people realize.
Understanding Limited Licenses in Michigan
Many mental health professionals begin their careers with what is referred to as a limited license.
Examples include:
- Limited Licensed Professional Counselors (LLPCs)
- Limited Licensed Master Social Workers (LLMSWs)
- Limited Licensed Marriage and Family Therapists (LLMFTs)
- Temporary Limited Licensed Psychologists (TLLPs)
Not sure what the difference is between an LPC, LMSW, LP, LLP, or LLPC? Check out my blog, What Are All Those Letters? Credentials and What They Mean, for a breakdown of common mental health credentials and licenses.
These professionals have earned graduate or doctoral degrees, completed extensive training, and are licensed by the State of Michigan. They are not students or interns.
The purpose of a limited license is to allow clinicians to gain experience while receiving supervision from a fully licensed professional. During this time, they sharpen their clinical skills, consult on complex cases, and gain the experience required for full licensure.
This supervision process is designed to benefit both clinicians and clients. Clients receive care from a qualified professional while also benefiting from the experience and knowledge of their supervisor.
Access to Care
Because limited licensed clinicians are still completing their state-required supervision hours, many insurance companies allow claims to be billed under the supervising clinician. The supervisor provides guidance while the limited licensed clinician provides the therapy services. After reviewing case notes, the supervisor signs them so they can be billed under their name and credentials.
The demand for mental health care continues to grow across Michigan and throughout the country. At the same time, many communities face provider shortages, long waitlists, and barriers created by insurance restrictions.
Supervised billing helps increase access to care by allowing qualified, supervised clinicians to serve clients while those clinicians work toward full licensure. Without these pathways, many limited licensed clinicians become unable to see clients covered by certain insurance plans, even though they are licensed by the State of Michigan and actively receiving supervision.
As of June 15, 2026, Michigan has approximately 37,637 fully licensed behavioral health professionals and 13,940 limited licensed professionals. That means roughly 27% of Michigan’s behavioral health workforce is currently practicing under a limited license while receiving supervision.
As demand for mental health services continues to increase, supporting the next generation of providers becomes increasingly important for maintaining access to care.
Location Shouldn’t Be a Credential
Large healthcare systems, hospitals, outpatient psychiatric clinics, and community mental health organizations all play an important role in our healthcare system. Private practices do too.
Many private practices focus on specific populations, treatment approaches, or areas of expertise. They often provide highly individualized care and allow clients to find providers who are the best fit for their needs. Contrary to how typical businesses operate, mental health providers are often highly collaborative. Therapists regularly consult with one another, coordinate care, and refer clients to psychiatrists, primary care physicians, testing specialists, schools, and other community resources outside of their own practices.
Our goal is not to hoard clients. Our goal is to help clients find the right care.
A therapist may be licensed by the State of Michigan, actively receiving supervision, qualified to provide care, and able to bill under their supervisor in one work setting but not in another.
For example, the same therapist may be able to see a client with Blue Care Network while working in a hospital system, intensive outpatient program, or outpatient psychiatric clinic, but not while working in a private practice. In other words, the difference isn’t the therapist’s education, training, supervision, or qualifications. Sometimes, it’s the classification of the organization where they work.
While some larger healthcare organizations are already structured in ways that meet these insurance requirements, transitioning a private practice into one of those models can be a lengthy, complex, and expensive process. For many private practices, it’s simply not a realistic option.
Many future therapists choose private practice because they are passionate about serving specific populations, developing specialized expertise, or providing care in a smaller and more personalized environment.
Why This Matter Today
This topic isn’t random.
Blue Cross Blue Shield of Michigan, the state’s largest health insurer, recently announced changes that will significantly limit the use of supervised billing in many private practice settings beginning September 1, 2026. Unless practices undergo significant organizational restructuring, many limited licensed clinicians will no longer be able to see BCBSM members using their insurance benefits.
Many providers are concerned about what these changes may mean for access to care, workforce development, and client choice. Some clients currently seeing limited licensed therapists in private practice may eventually need to transition to another provider or pay out-of-pocket if they wish to continue treatment. There is also concern that other insurers could adopt similar policies in the future.
It is important to understand that when providers speak about these issues, it is rarely because they don’t want to accept insurance. In fact, many providers are frustrated when they cannot offer services to someone who wants to use their insurance benefits.
Most therapists enter this profession because they want to help people. Practice owners want to hire talented clinicians. Clients want access to care. Those goals are remarkably aligned.
The challenge arises when insurance policies create barriers between qualified providers and the people seeking services.
The Bigger Question
At the end of the day, most people pay for health insurance with the expectation that they will be able to access healthcare when they need it.
Mental health care should be no different.
Clients deserve access to qualified professionals. Providers deserve fair opportunities to serve their communities. And insurance companies, providers, regulators, and healthcare organizations should be working collaboratively toward the same goal: increasing access to care.
Because when a licensed, supervised, qualified clinician is willing to see a client, and a client is willing to see that clinician, the question shouldn’t be, “What type of building does that clinician work in?”
The question should be, “How can we help that client get the care they’re already paying for?”
Have Questions or Concerns About Your Coverage?
If you are a BCBSM or BCN member and have questions about how insurance policies may affect your access to care, consider contacting them directly to learn more about your benefits and available provider options.
If you believe policies affecting mental health access should be reviewed, you can also share your concerns with your elected representatives. Legislators often rely on feedback from constituents when considering healthcare-related issues.
Your voice matters. Clients, providers, insurers, and policymakers all play a role in shaping access to mental health care in Michigan.