Understanding the NIHB Mental Health Program

If you're considering becoming an NIHB Mental Health Counselling Provider, it's helpful to understand how the program works before completing your enrolment package.

The Non-Insured Health Benefits (NIHB) Mental Health Counselling Program is a federally funded benefit that helps eligible First Nations and Inuit clients access professional counselling services. The program is administered by Indigenous Services Canada, with Express Scripts Canada managing provider enrolment, claims processing, and payments.

As an enrolled provider, your role is to deliver clinically appropriate counselling services while following NIHB policies for prior approvals, billing, documentation, and claim submission.

What Is the Purpose of the NIHB Mental Health Program?

The NIHB Mental Health Counselling Program is designed to improve access to short-term mental health care for eligible First Nations and Inuit clients across Canada.

The program aims to:

• Improve access to professional mental health services.
• Reduce financial barriers to counselling.
• Provide timely intervention during periods of emotional distress or crisis.
• Support clients while connecting them with longer-term community resources when appropriate.

Services may be delivered in person or virtually, helping improve access for clients living in rural, remote, and northern communities.

Who Can Provide NIHB Counselling?

Mental health services must be delivered by NIHB-enrolled providers.

To become enrolled, providers must:

• Hold an active licence with their provincial or territorial regulatory body.
• Be authorized to practise independently where required.
• Meet the eligibility requirements for their profession within their province or territory.
• Complete the NIHB Mental Health Counselling Provider Enrolment Package.

Eligible professions commonly include:

• Registered Social Workers
• Registered Psychologists
• Psychological Associates
• Registered Psychotherapists or Counselling Therapists (where eligible)
• Registered Psychiatric Nurses (where eligible)

How Counselling Sessions Are Approved

Eligible clients may receive up to 22 hours of counselling per calendar year.

The first 2 hours can generally be provided without prior approval, allowing the provider to complete an assessment and begin treatment.

If additional sessions are clinically indicated, the provider submits a Prior Approval request to NIHB outlining the client's treatment needs. Once approved, counselling may continue within the authorized number of hours.

This process helps ensure clients receive the level of care appropriate to their clinical presentation while supporting responsible administration of the benefit.

Direct Billing and Claims

One of the advantages of becoming an NIHB provider is the ability to bill approved counselling services directly through Express Scripts Canada.

In most cases:

• Eligible clients do not pay out of pocket.
• Providers submit claims electronically through the NIHB Provider Web Account.
• Payments are generally issued by direct deposit every two weeks after eligible claims are processed.

Because NIHB is the payer of last resort, any other available health insurance coverage is generally billed first before NIHB covers the remaining eligible costs.

Provider Responsibilities

Becoming an NIHB provider involves more than simply delivering counselling sessions.

Providers are expected to:

• Follow the NIHB Billing Agreement and Claims Submission Kit.
• Maintain accurate and complete clinical documentation.
• Submit prior approval requests when required.
• Keep provider information up to date.
• Comply with claim verification and audit requests if selected.
• Remain in good standing with their professional regulatory body.

Maintaining organized records and following current NIHB policies helps ensure claims are processed efficiently and reduces the likelihood of payment delays.

Supporting Culturally Safe Care

The NIHB Program recognizes the importance of culturally safe mental health services for First Nations and Inuit clients.

During enrolment, providers can choose to include information about:

• Indigenous mental health experience
• Cultural safety training
• Languages spoken
• Areas of clinical expertise
• Telehealth availability
• Populations served

This information may be included in provider directories used by communities and care coordinators to help connect clients with providers who best meet their needs.

Where to Learn More

Always use the official NIHB forms and guides.

NIHB forms and billing guides are updated regularly. Download the latest versions directly from Express Scripts Canada to ensure you have the most current information.

View Official Forms Page

The NIHB Mental Health Program is supported by several official provider resources, including:

• Mental Health Counselling Provider Enrolment Package
• Claims Submission Kit
• Prior Approval Guide
• Provider Web Account
• Provider Bulletins

These documents explain the administrative requirements in greater detail and should be reviewed alongside your professional regulatory standards.

Final Thoughts

Understanding how the NIHB Mental Health Counselling Program works before applying can make the enrolment process much easier. Once enrolled, providers become part of a national network helping eligible First Nations and Inuit clients access timely, culturally safe mental health care across Canada.

By becoming familiar with the program's approval process, billing requirements, NIHB documentation expectations, and provider responsibilities, you'll be well prepared to successfully integrate NIHB services into your practice.