There are many services that Medicaid/Medicare will not pay for, and clinicians need to be aware of these in order to be better at even make the decision to take out insurance like this. . Medicaid may not even be billed simply because you hold an LPC (Sturm & Gibson, 2012), especially if you are not employed by a community mental health facility. Some insurance companies want diagnoses to be made immediately, I don't like working like that (Dumesnil, 2014). There are cases where clients will push for a diagnosis that insurance will pay for, but you just can't make a diagnosis like that. This can feel like a barrier for customers to get the help they need. Because insurance companies like Medicaid often want these immediate diagnoses and tend not to pay for private practice LPC services, less financially privileged clients are sent to community agencies potentially staffed with less qualified interns and counselors (Sturm & Gibson,