Certification in General Biofeedback is open to professionals from clinical health care areas including, but not limited to, psychology, nursing, counseling, and therapy who hold a degree from a regionally accredited academic institution. A complete list of accepted degree fields is found in this brochure.
Candidates must file an application and demonstrate completion of:
The first step to certification is filing an application. Once your application has been approved and fees received, you may schedule a time for your exam. A completed application must include a signed, sealed, original transcript and payment of filing fees. You may complete your requirements in any order. You may order your application packet from BCIA for $25. If you download the application packet from the website, your filing fee will be $125. The documents included are: Application, Application Instructions, Blueprint, Mentoring Guidelines, Suggested Reading List, Ethical Principles, and Exam Registration Form.
All candidates must agree to abide by the BCIA Ethical Principles and follow the appropriate rules and regulations of their profession and their state.
Certification is valid for four years. To recertify, the candidate must demonstrate completion of 80 hours of continuing education and must attest that their license/credential has not been suspended, investigated or revoked.
(30 Hours over a minimum of 10 weeks)
Individual arrangements can be made through Phillip Hughes, Training Director, Stens Corporation, to provide up to 30 hours of BCIA Clinical Biofeedback Supervision. Of these hours, three must be in the form of direct observation (audio tape, video tape or in person). Small group conferencing is available at a reduced fee.
Members of the Stens Corporation Board of Advisors who are located around the US may also act as clinical supervisors. Stens will be happy to help you contact our Advisors to make your supervision arrangements.
Direct Clinical Biofeedback Treatment
(90 Hours over a minimum of 10 weeks)
Trainees will acquire 90 hours of Direct Clinical Treatment with patients over a minimum of 10 weeks. It is the responsibility of the trainee to arrange for a field placement. Stens Corporation learns of a limited number of field placements around the US. When they are available, Stens is happy to share them with our students.
BCIA General Neurofeedback Certification Information
Certification in neurofeedback is strictly limited to EEG biofeedback or brainwave training.
This neurofeedback (EEG biofeedback) certification is open to professionals from clinical health care areas including, but not limited to, psychology, nursing (includes all licensed RN's), counseling, and therapy who hold a degree from a regionally-accredited academic institution (an Accredited Institution of Post-secondary Education as determined by the American Council on Education). If you are unlicensed, a signed, sealed, original transcript from the university that granted your highest degree must be directly submitted to BCIA. If you carry an appropriate state-issued credential that allows you to practice independently in your state, please submit a copy of that license.
BCIA-approved health care fields include: psychology, nursing, (including 2-year registered nurses with license; not LVNs or LPNs), physical therapy, occupational therapy, social work, counseling, rehabilitation, chiropractic, recreational therapy, physician's assistant (with certification or license), exercise physiology, speech pathology, and sports medicine. The following fields require a master's degree: music therapy and counseling education (M.Ed. in counseling). Appropriately credentialed doctors of medicine are also accepted. Credentialed special education teachers may be certified to work in educational environments. Degrees in health care fields other than those listed above must be submitted to the Certification Review Committee.
Only the highest degree earned in a BCIA approved health care field from a regionally accredited academic institution will be listed on the Find a Practitioner area of this website.
Only the highest degree earned in a BCIA approved health care field from a regionally accredited academic institution will be listed on the Find a Practitioner area of this website.
BCIA will consider requests for special review for the demonstration of equivalency for most of our requirements, including prerequisite education. However, degree review requests must be compared to a BCIA-approved clinical health care field.
BCIA welcomes appropriately credentialed health care professionals from any country or region outside the United States and Canada. Until such time as a country or region forms a BCIA affiliate organization (a la Australia), then BCIA will require all applicants for certification who reside outside the US or Canada to demonstrate that they have a license to practice in an approved health profession in the country where they reside. Degrees earned outside the United States must be translated and evaluated by an organization that is a member of the National Association of Credential Evaluation Services (NACES) at www.naces.org.
Filing an Application
Candidates may file an application at any time during the certification process and pay all fees. Fees include $150 filing fee which must be paid at the time the application is submitted plus a $275 certification fee, a total of $425. The filing fee will be reduced to $50 if an applicant can document that he/she is currently enrolled in an advanced degree program at a regionally-accredited academic institution in a BCIA-approved health care field. Total fees for current students in this category amount to $325. All fees must be in US funds and paid by check, money order, or credit card. For additional information about the application refer to the Application Instructions. More detailed information about the certification process may be found in the BCIA Policies, Exams, and Fees. If this is your second BCIA certification (in addition to either the BCIA Biofeedback or PMDB), the total fees for dual certification are $220.
The application includes a line for your signature attesting that you have read and agreed to abide by the BCIA Professional Standards and Ethical Principles of Biofeedback document.
The first step to certification is filing an application. Application documents include: Application, Application Instructions,Blueprint of Knowledge, Mentoring Guidelines, Core Reading List, Professional Standards and Ethical Principles of Biofeedback, and Exam Registration Form.
You must agree to abide by the BCIA Professional Standards and Ethical Principles of Biofeedback and follow the appropriate rules and regulations of your profession and your state. Requirements may be completed in any order.
A completed application must include a signed, sealed, original transcript to be received directly from the granting institution if you are unlicensed, and payment of filing fees. If you carry a valid state-issued health care license, you may submit a copy of your license without the transcript. Once your application has been approved and fees received, you may schedule a time for your exam.
Candidates must demonstrate the completion of:
Practical Skills Training
Written Certification Exam
The exam may be taken at any time after approval of your application; however, we recommend it as the last requirement in the certification process. The examination is offered in English only and is based on the Blueprint of Knowledge Statements. The exam consists of 100 multiple-choice items sourced from the Core Reading List. The number of exam items from a blueprint area correspond to the number of hours in that rubric; the smaller the rubric, the fewer questions will be in the exam from that content area.
License for Independent Practice
When treating a medical or psychological disorder, you are required to hold a current license/credential issued by the state in which you practice in a BCIA-approved health care field. Without this license/credential, you must agree to work under the supervision of an appropriately-credentialed health care professional when working with a medical or psychological disorder.
QEEG Certification Board Blueprint for Certification
The purpose of the Board is to certify the competence of individuals in obtaining an EEG and interpreting a QEEG. The applicant should do the following (steps can be taken out of order).
Your application will alert us that you’re interested in ascertaining QEEGT or QEEGD certification. It’s helpful to have your application on file so we can guide you appropriately. There is a $200 application fee payable when the application is submitted. You can pay HERE or by sending a check to our office (address below).
Contact a diplomat or diplomats to arrange for him/her to review 5 QEEGs (those seeking technologist status must complete 5 acquisitions; those seeking diplomat status must provide acquisition and interpretation). The diplomat(s) review(s) the 5 QEEGs for competence and provides confirmation and referral of the candidate to the QEEG Board and completes the QEEG Board's certification Board. John Anderson, M.A., instructor of Stens' 4-Day Neurofeedback EEG/QEEG & 5-Day QEEG Courses, and is an certified mentor by the QEEG Board.
As a candidate, you may request access to the reading lists:
We will send you a password to access the reading lists once you provide proof of mentorship (a letter from your mentor or him/her filling out the required form provided by QEEG Board)
Attend an accredited didactic course. Stens' 4-Day Neurofeedback EEG/QEEG or 5-Day Quantitative Neurofeedback QEEG courses are accredited by the QEEG Board and fulfill the didactic requirement needed for certification.
BCIA General Heart Rate Variability Certification Information
BCIA’s Certificate of Completion in HRV biofeedback confirms that a professional has successfully completed an educational program recognized by the biofeedback field. We believe that building and maintaining educational standards is crucial for all biofeedback modalities to gain respect from the health care community and to take their rightful place alongside other recognized treatments.
A certificate of completion demonstrates that an applicant has successfully completed an approved and standardized didactic workshop based on fundamental science that meets rigorous academic standards. Following a needs assessment, BCIA concluded that an HRV certificate of completion would better promote BCIA’s educational mission than a new certification. A certificate could increase the rigor of didactic programs teaching HRV biofeedback and enhance the expertise of academics, technicians, performance specialists, and licensed health care professionals who utilize HRV biofeedback.
Who can earn this certificate?
The HRV certificate of completion is intended for anyone who wants to demonstrate that they have followed a standardized training program to learn how to use this modality, but specifically for:
Where do I start?
The first step is to file an application. All applicants must:
1. agree to abide by BCIA’s Professional Standards and Ethical Principles (PSEP),
2. complete a BCIA-approved HRV biofeedback didactic program,
3. document completion of 3 hours of ethics/professional standards course work, taken within the last 5 years
4. pass a nationally-standardized online exam based on the 15-hour Blueprint of Knowledge, based on this reading list.
Applicants must complete 15 hours of didactic education in HRV by an accredited course provider.
The Stens Corporation offers 2 HRV courses that, in combination, fulfill the BCIA didactic requirements: 2-Day Advanced Biofeedback HRV and Pain Applications and Everything You Wanted to Know About HRV Online Course.
Software for Review of Biofeedback, Neurofeedback, and HRV Concepts and On-site and International Training Opportunities
Biofeedback-100 , Neurofeedback-100 and HRV Tutor are computer-based reviews of pertinent biofeedback and neurofeedback concepts and vocabulary. Self-Assessment in Biofeedback & Neurofeedback, based on the BCIA test blueprint, provides a multiple choice exam with answer key to help identify your strengths and weaknesses as you prepare for the exam. They can be ordered from the Stens Corporation at 1-800-257-8367.
In certain circumstances, it may be practical to bring our training program to your site, especially if you are located outside of the US and have a group of 15 students or more. Contact Stephen Stern at 1-800-257-8367 for fees and further information.
Ronald Rosenthal, PhD
In an ideal world, we would be able to generate a long list of insurance companies and managed care organizations that have consistently paid for biofeedback services. However, the world we live in is far from ideal and insurance reimbursement for biofeedback continues to be inconsistent and unpredictable.
In order to try to bring some order to this topic, it is important to remember how third party reimbursement works. When billing to third party payers, we need to complete (accurately) a claim form that provides specific information about what we did. In addition to the basic demographic information identifying your client, the claim form will include a diagnosis code and a procedure code. All of the decisions regarding payment will be based upon the combination of codes you provide.
The first step in the process is to contact the insurance company and verify coverage. The basic details of coverage may be available on-line, but it you want to determine if you will be paid for biofeedback services, you will need to call the insurance company. Payment may be restricted to participating providers or there may be higher deductibles and increased copays if you are not a network provider. Some services may also require preauthorization
Many insurance companies have (long) lists of excluded services, and the biofeedback codes are often on these lists. In other cases, the procedure codes will only be paid if the diagnosis code is from a list of covered conditions. As an example, the basic mental health procedural codes, like 90806, used by psychologists and counselors are only covered when the diagnosis is for a psychiatric or developmental disorder.
There is a relatively small set of procedural codes for biofeedback. There are two pure biofeedback codes, 90901 and 90911. The 90901 code is for any modality of biofeedback and the 90911 code is pelvic floor training for the treatment of incontinence. There are also two codes for mental health providers, 90875 and 90876. These refer to sessions that combine biofeedback with some kind of talk therapy or counseling—90875 for a 25 minute session and 90876 for a 50 minute session In addition to the codes listed above, some practitioners have been billing using codes from the physical medicine section of the code book or with the new health and behavior intervention/assessment codes. The use of these other codes reflects the complex and diverse ways that biofeedback training can be used. Most biofeedback practitioners believe in an integrated treatment approach in which biofeedback training is just one part of a package. Other modalities could include counseling, breathing training, relaxation and meditation techniques, Feldenkrais exercises, Tai-Chi, yoga, and so on. The basic biofeedback codes may not reflect accurately all of what is done within a session.
The set of alternative codes that have been used with biofeedback include 96150 and 96152, 97532, 97112. 96002 and 90806. The 90806 code is for psychotherapy, not biofeedback, and providers combining biofeedback and psychotherapy are advised to use 90876 or 90875,. Some providers may be tempted to use 90806 when 90876 is not covered, but this can be considered to be a misrepresentation and leaves one open to charges of insurance fraud. Many clinicians have reported that insurance company representative have told them to use the 90806 when 90876 is not covered, but unless these instructions are obtained in writing, a significant risk remains. The health and behavior codes, 9615x, were released in 2002. They are used for the assessment or treatment by a psychologist of patients with primarily a physical complaint diagnosed by a physician. These codes recognize the mind/body connection and the interplay of biopsychosocial factors in the expression of health and disease. In many cases, a legitimate case for the use of these codes can be made for treatment that includes biofeedback for patients with chronic medical conditions such as headache, hypertension or fibromyalgia.
The health and behavior codes are time based codes. They are billed in 15 minute units and permit billing for extended sessions, e.g., 6 units for a 90 minute evaluation. They must be linked to a medical diagnosis given by a physician. It was intended that payment for these codes would come from the general medical pool of funds, not from mental health funds. In practice, the use of the medical diagnosis has caused problems at times because some insurance companies require the use of only mental health codes by psychologists.
The 97532 code refers to cognitive retraining; it has typically been used by speech and language pathologists working to improve cognitive function of patients with cognitive deficits. Many neurofeedback providers have started to use this code when working with clients with ADHD or TBI. The 97112 code refers to neuromuscular retraining of movement, balance or coordination. Surface EMG training (as well as some less common techniques) in rehabilitation settings can be coded with 97112. I have also come across a relatively new code, 96002, that is used for dynamic surface EMG recording for gait training and other functional activities. We may be able to use this code when providing EMG biofeedback to improve motor control
Medicare will pay for CPT codes 90901 and 90911 when specific criteria are met. Medicare does not reimburse for 90876. Under Medicare guidelines, biofeedback training for muscular pain or weakness may be eligible for payment. Each carrier will have a list of eligible diagnoses and you would have to check to see what conditions are eligible for your local carrier and whether you can be reimbursed as a provider.
The main concern when billing Medicare with 90901 is that reimbursement is quite low. The allowance is between $40-50 per session, regardless of the length of the session. The reimbursement for 90911 is typically higher. Billing Medicare for 90901 also requires the use of a modifier (GP or GN) to indicate whether the services are coordinated with physical therapy or occupational therapy.
All of the Medicare carriers are now paying for the health and behavior intervention codes. In Florida, the allowance is $97 for the evaluation (96150—1 hour or 4 units) and $89 for individual treatment (96152—1 hour or 4 units).
I don’t have information on Medicare coverage of 97532. Since the vast majority of clients getting neurofeedback for attention deficit disorder are children, it is highly unlikely that they will have Medicare for insurance.
The federal workers’ compensation program (http://owcp.dol.acs-inc.com/portal/main.do) will pay for biofeedback training. The enrollment process can be tedious, but once you are enrolled as a participating provider, you can bill for biofeedback services provided to federal employees who are injured on the job.
With regards to the major insurance carriers, it is impossible to give any universal advice. Many providers have reported success in getting reimbursement for biofeedback services, but it often requires getting authorization on a case-by-case basis. Certification by BCIA has been helpful as well as documentation from AAPB’s Evidence-Based Practice in Biofeedback and Neurofeedback. Neurofeedback providers have reported that having a QEEG brain map has been helpful in getting authorization or reimbursement. Blue Cross/Blue Shield has long been considered to be quite negative in its views about biofeedback, but several providers have reported success in getting paid by Blue Cross for biofeedback. In addition, we have reports of biofeedback reimbursement from Aetna, United and Delta on the West coast.
The best advice is to be persistent and prepared. Have your office verify coverage for all possible biofeedback codes for all of your patients. Coverage often varies widely based upon the specifics of a given contract and may include restriction based upon type of licensure. If you get a rejection initially, contact a supervisor, case manager or provider relations. If you have success, let us know at AAPB or BCIA.