1. What is psychedelic-assisted therapy?
Psychedelic-assisted therapy is a mental health treatment that combines psychotherapy with the controlled use of psychedelic substances. It’s a structured process aimed at treating various mental health conditions providing new pathways for healing and recovery.
2. When did Alberta regulate psychedelic-assisted therapy?
Alberta became the first province to regulate psychedelic-assisted therapy in the fall of 2022.
3. What treatments are included in coverage?
Psychedelic therapy treatments, including associated services like assessment, drug administration, and monitoring that is performed on the same day as the therapy, are eligible for reimbursement. Coverage depends on the member’s plan and the specific services provided during the session. If you are a member, you can log in to your Alberta Blue Cross Member Services account to look up the specific drugs and psychology services eligible for coverage.
Member Services will show
- psychology coverage maximums,
- per visit frequency maximums, and
- which mental health practitioners are eligible under the member’s psychology benefit.
Depending on your plan, coverage will be limited to
- providers approved to perform psychedelic-assisted therapy,
- the usual and customary fee for psychology, and
- the member’s per visit coverage maximum.
4. What medications are covered?
The psychedelic drug must be a covered product under the your drug plan in order to be eligible. It must be prescribed by a psychiatrist or an appropriately trained physician in consultation with a psychiatrist, then dispensed from a licensed pharmacy. The receipt from the pharmacy must
- be in the member’s name,
- include the DIN of the drug dispensed, and
- be submitted as a drug claim.
Drugs that are purchased and dispensed from non-pharmacy locations (e.g., medical facilities or clinics) will not be reimbursed.
5. Who is eligible to provide psychedelic-assisted therapy in Alberta?
Only psychiatrists, clinical psychologists, or regulated healthcare professionals registered with specific colleges in Alberta are authorized to provide psychedelic-assisted therapy. These include:
- Alberta College of Occupational Therapists,
- College of Physicians and Surgeons of Alberta,
- College of Alberta Psychologists,
- College of Registered Nurses of Alberta,
- College of Registered Psychiatric Nurses of Alberta,
- Alberta College of Social Workers.
6. How can patients or providers inquire about eligibility and claims?
For questions about eligibility or the claim submission process, patients can contact the Customer Services line at Alberta Blue Cross. Providers with questions or concerns are encouraged to reach out to the Provider Relations Contact Centre. Contact details are provided for both local and toll-free lines, along with email support.
7. Are there any prerequisites for patients before undergoing psychedelic-assisted therapy?
It is required that patients undergo a comprehensive assessment by a qualified provider to determine their suitability for psychedelic-assisted therapy. This includes evaluating mental health history, current condition, and potential risks or contraindications.
8. What information is required on an invoice for psychedelic therapy claims?
Invoices should include:
- Service dates for every treatment,
- Descriptions of services provided,
- Costs for each product/service,
- Provider’s name, address, and registration numbers,
- Patient’s name.
9. Can all plan members access psychedelic therapy coverage?
Coverage for psychedelic therapy is subject to member’s plan maximums, existing plan coverage, and provider eligibility criteria. Members are encouraged to review their specific plan details or contact Alberta Blue Cross for more information on their eligibility.
10. How significant is this regulation and coverage change for mental health treatments in Alberta?
Regulating and covering psychedelic- assisted therapy marks a significant step forward in mental health treatment options available in Alberta. It recognizes the potential of psychedelic substances in therapeutic settings and ensures regulated, safe access for patients seeking alternative treatments.
11. Is there a limit to the number of psychedelic therapy sessions covered?
Coverage for psychedelic therapy is subject to the member’s plan maximums, existing plan coverage, and provider eligibility criteria. Members are encouraged to review their specific plan details or contact Alberta Blue Cross for more information on their eligibility.
For more detailed information or specific questions not covered in this FAQ, please contact Alberta Blue Cross directly at Customer Services line at 780-498-8000 (Edmonton & area) or 1-800-661-6995 (toll free).
12. I have Blue Cross and I paid for psychedelic drug treatment services 11 already. Can Blue Cross?
Please contact Blue Cross directly to discuss your concern. If you are a clinic or practitioner and have further questions, please call the Blue Cross Provider Relations Contact Centre at 780-498-8083 (Edmonton and area) or 1-800-588-1195 (toll free) Monday to Friday, 8:30 a.m. to 5 p.m. Mountain Time. You can also reach them by email at healthing@ab.bluecross.ca