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Practitioner Eligibility Reference (Canonical)

Updated: March 19, 2026 Owner: @Michael Nguyen Purpose: Help the chatbot answer questions about which types of practitioners may use Thrizer.

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Overview

Thrizer helps clients use out-of-network (OON) insurance benefits and simplifies payments between clients and healthcare practitioners. The platform is most commonly used by mental health clinicians, but the underlying insurance and payment workflow may apply to a wider range of licensed healthcare providers. This document lists practitioner types the chatbot should recognize when answering eligibility questions. Currently we are in pilot phase with Occupational Physical Therapists, medical specialist, registered dieticians. These clinicians may see more denial rates initially as we learn how to handle these cases. We do not yet support chiropractors, and message therapists. We do support music under the broad therapeutic CPT code. Practitioner eligibility ultimately depends on:

• The provider’s license
• Whether the provider is legally allowed to provide the service
• Whether the service may be eligible for insurance reimbursement

The chatbot should avoid guaranteeing eligibility without these conditions.

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Core Mental Health Clinicians

These practitioner types are most commonly associated with Thrizer.

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Social Workers

Common licenses:

• LCSW — Licensed Clinical Social Worker
• LICSW — Licensed Independent Clinical Social Worker
• LMSW — Licensed Master Social Worker

Social workers commonly provide psychotherapy and behavioral health services.

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Marriage and Family Therapists

Common licenses:

• LMFT — Licensed Marriage and Family Therapist
• AMFT — Associate Marriage and Family Therapist

These clinicians specialize in relationship and family therapy. Associates typically practice under supervision.

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Professional Counselors

Common licenses:

• LPC — Licensed Professional Counselor
• LPCC — Licensed Professional Clinical Counselor
• LCPC — Licensed Clinical Professional Counselor
• LMHC — Licensed Mental Health Counselor

These clinicians provide psychotherapy and behavioral health treatment.

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Psychologists

Common licenses:

• Clinical Psychologist (PhD or PsyD)

Psychologists provide therapy, psychological testing, and behavioral health services.

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Psychiatrists

Common licenses:

• Psychiatrist (MD or DO)

Psychiatrists are medical doctors who specialize in mental health and can prescribe medication.

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Psychiatric Nurse Practitioners

Common licenses:

• PMHNP — Psychiatric Mental Health Nurse Practitioner

These clinicians can provide therapy and medication management.

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Other Behavioral Health Practitioners

Some related provider types may also appear in Thrizer workflows.

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Behavioral Analysts

Example:

• BCBA — Board Certified Behavior Analyst

These clinicians often provide behavioral therapy services.

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Addiction Counselors

Examples:

• CADC — Certified Alcohol and Drug Counselor
• Licensed Substance Use Counselor

These practitioners specialize in addiction treatment.

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Other Healthcare Practitioners (Outside Traditional Therapy)

Some healthcare services outside mental health may also involve out-of-network reimbursement.

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Occupational Therapists

License example:

• OT — Occupational Therapist

These practitioners help patients develop or regain daily living skills.

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Speech Language Pathologists

License example:

• SLP — Speech Language Pathologist

These practitioners treat speech and communication disorders.

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Physical Therapists

License example:

• PT — Physical Therapist

These practitioners treat movement and physical rehabilitation conditions.

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Registered Dietitians

License example:

• RD or RDN — Registered Dietitian Nutritionist

These practitioners provide nutrition counseling.

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Medical Specialists

Examples:

• Physicians (MD / DO)
• Nurse Practitioners
• Physician Assistants (PA)

These providers may offer services that can be reimbursed through insurance.

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License Status

Practitioners may appear in two general licensing categories.

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Fully Licensed Practitioners

These practitioners can practice independently. Examples:

• LCSW
• LMFT
• LPC
• Psychologist
• Psychiatrist
• Nurse Practitioner

These providers usually submit insurance claims under their own license.

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Pre-Licensed or Supervised Practitioners

These practitioners are completing licensure requirements and must practice under supervision. Examples:

• AMFT
• APCC
• Associate therapist
• Intern
• Resident
• Limited license clinician

Insurance reimbursement rules vary for these providers. Some insurance plans do not reimburse services from supervised practitioners.

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Licensing Jurisdictions

Healthcare licenses are issued by state or territorial licensing boards. Practitioners may be licensed in the following jurisdictions.

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U.S. States

All 50 U.S. states maintain independent licensing boards. License titles and requirements vary by state. Example differences: California commonly uses:

• LCSW
• LMFT
• LPCC
• AMFT
• APCC

New York commonly uses:

• LCSW
• LMSW
• LMHC

Texas commonly uses:

• LCSW
• LPC
• LMFT

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District of Columbia

Washington D.C. operates as a separate licensing jurisdiction.

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U.S. Territories

Practitioners may also be licensed in U.S. territories. Examples include:

• Puerto Rico (PR)
• Guam (GU)
• U.S. Virgin Islands (VI)
• American Samoa (AS)
• Northern Mariana Islands (MP)

Puerto Rico is the territory most commonly encountered. Licensing structures may differ slightly from those in U.S. states.

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Telehealth Across States

Some clinicians can practice across multiple states through interstate licensure compacts. Examples: PSYPACT — psychologists Nurse Licensure Compact — nurses and nurse practitioners Counseling Compact — professional counselors Social Work Compact — social workers (emerging) Insurance reimbursement often depends on the location of the client during the session.