Try for free

NIHB Mental Health Counselling Prior Approval/Claim

Enrolled Non-Insured Health Benefits counselling providers use this form to request prior approval for counselling beyond the initial assessment, ask for extra hours as an exception, get post-approval for services already given, and claim by fax or mail. NIHB covers up to 22 counselling hours per client per calendar year. Prior approval also confirms the client isn't in active treatment elsewhere.

Who completes it

The enrolled mental health counselling provider, such as a psychologist or counsellor licensed in the client's region, completes the provider sections. The client signs the form when in-person counselling is claimed by fax or mail.

Submitting and payment

How to submit it
Prior approval requests can go through the prior approval field in the provider's web account; exception requests go to the NIHB regional office by fax or email with a rationale. Claims go through the web account, by fax or by mail, within one year of the service date.
Who pays
NIHB pays enrolled providers directly through Express Scripts Canada at their usual and customary rate, up to the regional fee grid maximum, once any other insurance has been billed first.

Good to know

  • The first 2 hours of initial assessment can start without prior approval and are post-approved; the remaining 20 hours of the yearly 22 need prior approval.
  • Exception requests for more hours must describe the frequency and duration of counselling needed and the expected completion date of the treatment plan, which the program may ask to see.
  • Prior approval requests are assessed within 5 business days, 80% of the time, once complete documentation arrives. Include the assessment hours in the request so they are paid.
  • A provider can bill at most 8 counselling hours a day. No-shows, cancellations and non-counselling time aren't covered, and the fee includes reports and other administrative work.

Get the official form

Download the current version from the source each time; forms change without notice.

Mental Health Counselling Prior Approval and Claim Form (NIHB)

Official page

Get the note ready with Vero

This form isn’t published as a fillable PDF. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.

See how Vero Scribe works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Does the client need to sign the NIHB counselling claim form?

Yes, for in-person counselling claimed by fax or mail. Adults sign for themselves, clients aged 14 to 18 may sign if they have capacity, and a parent or guardian generally signs for children under 14. Online claims need no form signature, but the provider must keep session records showing the client's confirmation.

How many counselling hours does NIHB cover?

Up to 22 hours per client per calendar year: up to 2 hours of initial assessment, which can start without prior approval, and up to 20 more hours with prior approval. Additional hours in the same year are covered only as an exception, with a rationale and treatment-plan details sent to the regional office.

Who can enrol as an NIHB mental health counselling provider?

Providers registered in good standing with a provincial or territorial regulatory body, eligible for independent practice, and listed among the eligible provider types in the NIHB Mental Health Counselling Benefits Guide. They must be licensed and enrolled with Express Scripts Canada in the region where the client is located, including signing the Mental Health Counselling Billing Agreement.