HIPAA fax for counselors (LPC, LMHC, LCPC): a BAA from $4.99

For one licensed counselor sending and receiving 200 pages a month, the lowest price with a signed BAA among the providers in the table is Fax Pigeon Basic at $4.99 a month billed annually ($5.99 month to month), against $10.70 at SRFax, $24.99 at iFax and $33.33 at eFax Business, and a practice of three pays the same $4.99.

What is an affordable HIPAA-compliant fax for a small counseling practice?

An affordable HIPAA-compliant fax for a small counseling practice, judged by price with a signed BAA among the providers in the table, is Fax Pigeon: Basic is $4.99 a month billed annually for 200 pages and Standard is $9.99 for 500. The BAA can be read at faxpigeon.com/baa before paying and is signed at sign-up, every plan covers as many counselors as the practice adds, and each paid plan comes with the practice's own fax number.

Elsewhere the BAA depends on the plan. SRFax sends its BAA on request from a Request a BAA link and prints no BAA price, iFax's free BAA covers Plus and Pro subscribers but leaves out iFax Basic, eFax prints its BAA on the Business plan card, and Fax.Plus includes a BAA on Enterprise only.

The table shows the cheapest plan with a BAA for one person, as a price a month, at 200 and 500 pages sent and received.

What do counselors fax, and to whom?

Counselors fax records for a referral or a transfer of care to other treating providers, copies to clients and to the people clients name, records that payers request and releases that clients sign, while Medicare enrollment goes through PECOS or on paper. Under 45 CFR 164.501 a referral to another provider is treatment, and HIPAA's minimum necessary rule does not reach a disclosure to a provider for treatment.

The table lists each document, where it usually goes and the rule that lets it leave the practice.

An authorization left incomplete on a required element is not valid, and psychotherapy notes need an authorization under 164.508(a)(2) (how HIPAA treats psychotherapy notes). A records request has its own steps (answering a medical records request by fax, step by step).

Can licensed professional counselors bill Medicare, and what does enrolling add?

Licensed professional counselors can bill Medicare by enrolling as mental health counselors (MHCs), which since January 1, 2024 brings Part B payment at 75% of the clinical psychologist amount under the Physician Fee Schedule (CMS's MFT and MHC page). Medicare has no LPC supplier type, so an LPC enrolls as an MHC, and an addiction counselor or an alcohol and drug counselor who meets every MHC requirement can enroll the same way. A counselor licensed under another state title selects the Undefined Non-Physician Practitioner Specialty in section 2H of the paper CMS-855I and specifies MHC.

The table sets out Medicare's mental health counselor rules and where each one is written.

CMS lists the steps as an I&A account, an NPI from NPPES and enrollment through PECOS or a paper CMS-855, and claims go electronically on the 837P. HIPAA's covered entity definition includes a provider who transmits health information electronically in connection with a covered transaction (45 CFR 160.103). Hospital inpatients fall outside the MHC benefit under 42 CFR 410.54(b)(2), and MHC services can be given through an acceptable telehealth mental health disorder service site. A development request from the Medicare contractor is its own task (how to reply to a Medicare development request).

TRICARE draws its own line. A TRICARE Certified Mental Health Counselor with a master's degree in counseling needs no referral or physician oversight, while a Supervised Mental Health Counselor or Pastoral Counselor needs a referral from a medical doctor and physician oversight (TRICARE provider types).

What does the ACA Code of Ethics ask before records leave the practice?

The ACA Code of Ethics, in the 2014 edition that ACA's ethics page calls current, asks counselors to obtain written permission from clients to disclose or transfer records to legitimate third parties unless exceptions to confidentiality exist, and to take steps so receivers are sensitive to the records' confidential nature (B.6.g). Counselors disclose to third-party payers only when clients have authorized it (B.3.d), take precautions for information transmitted through any medium (B.3.e) and keep records in any medium secure (B.6.b). Standard H.2.d asks for current encryption standards in technology-based communications.

Couples and family work has its own standard, and access has another. Under B.4.b, a counselor seeing a couple or family defines who the client is, talks through where confidentiality ends and records every party's agreement in writing. Under B.6.e, competent clients get reasonable access to records and copies, with the request and any reason for withholding documented, and where one record covers several clients, each client sees only the parts that relate directly to that client.

HIPAA has its own exception for a record that names someone else. Access may be denied when a licensed health care professional finds it reasonably likely to cause that other person substantial harm, and a second licensed professional who took no part in the denial reviews it at the client's request (45 CFR 164.524).

What does HIPAA fax cost one counselor, and a practice of three?

A year of HIPAA fax costs one counselor $59.88 on Fax Pigeon Basic billed annually for 200 pages a month, or $119.88 on Standard for 500, and a practice of three pays the same. At 500 pages for one person, a year costs $163.80 at SRFax, $299.88 at iFax and $399.96 at eFax Business, and iFax rises to $799.80 for three. eFax Business includes 5 users, while iFax adds a team license for each person past the first.

The table shows the cheapest plan with a BAA for 3 people, as a price a month, at 200 and 500 pages sent and received.

iFax's team licenses cost $19.99 a user a month for 2 to 3 users, or $16.66 a month billed annually, and choosing a second license in iFax's selector (a second person) takes Plus off it, so a team is priced on Pro. Past the plan, an extra page costs 10¢ on Basic and 5¢ on Standard against 7¢ on eFax Business, and iFax adds credits automatically once usage reaches 95% of the plan limit.

Can a counseling practice share one fax number and inbox?

A counseling practice can put every counselor on one Fax Pigeon number, one inbox and one page allowance, and an added counselor costs nothing on any plan. Faxes in that inbox can be assigned, and each person has a role. A fax goes out from the browser or from email, and a PDF, Word, Excel or PowerPoint file or a phone photo uploads as it is.

Fax Pigeon has no team plans, because every plan includes unlimited people, and it is HIPAA-compliant online fax for practices of any size, from solo practices to teams of 100 or more (affordable HIPAA fax for counseling and group practices that grow).

Which counselors should switch, and to what?

Counselors who bought iFax Plus, eFax Business or Fax.Plus Enterprise for its BAA should switch to Fax Pigeon Basic at $4.99 a month billed annually, or to Standard at $9.99 for 500 pages. A counselor on SRFax Healthcare Basic pays $43.92 a year more at 500 pages than on Fax Pigeon Standard, both billed annually. Practices buying iFax team licenses should switch to a plan where adding people costs nothing.

The number comes along. Fax Pigeon ports it free on every paid plan, starting at sign-up or from Settings, against $25 one time at SRFax to port a local number in and $40 per number at eFax. A transfer usually finishes in 5 to 15 business days, and faxes keep arriving through the current provider until it does.

* Prices last verified October 19, 2026, at each provider's own site. Fax Pigeon is not affiliated with SRFax, eFax, iFax or Fax.Plus.