LMSW vs. LCSW: What Each License Lets You Do

The short version: an LMSW is a master's-level license that, in most states, lets you practice social work broadly but do clinical work only under supervision. An LCSW is the independent clinical license that lets you diagnose and treat on your own. Between them sit two years or more of supervised clinical practice and the ASWB Clinical exam.

The longer version depends on the state, because neither title is uniform. Kentucky's master's license is the CSW, Illinois's is the LSW, Minnesota's is the LGSW. Massachusetts uses LCSW for the master's level. Michigan's top license is an LMSW. Read "LMSW" below as "your state's master's-level license" and "LCSW" as "your state's independent clinical license." The clinical titles glossary maps the names.

What can each license do?

Clinical work

New York's definition is the clearest: "the LMSW may only provide 'clinical social work' services (diagnosis, psychotherapy, and assessment-based treatment planning) under supervision; the LCSW may provide those services without supervision." Most states draw the line in roughly that place, with differences in who may supervise and in what setting.

• Louisiana lets LMSWs practice clinical social work only within an agency, under LCSW supervision.
• Kentucky lets a CSW practice clinical social work only under a board-approved supervision contract with an LCSW.
• Massachusetts lets its master's-level LCSW do clinical work only as an employee, with at least an hour a week of individual supervision from an LICSW.
• Maryland requires that an LMSW providing clinical services, including teletherapy, be supervised by a board-approved LCSW-C supervisor.

More in can an LMSW provide therapy?

Non-clinical work

Case management, advocacy, community and policy work, administration and research are where the master's license is broadest. Some states still want those services supervised for a period; others let the master's licensee practice them independently. A few have separate advanced non-clinical licenses: Minnesota's and the District of Columbia's LISW and Missouri's LAMSW are examples. Maryland stopped issuing its non-clinical LCSW after December 31, 2023 and now lets LBSWs and LMSWs apply for board approval to practice independently after 4,500 supervised hours over three years.

Can I have my own practice?

As an LCSW, yes, subject to ordinary business rules. Alabama is one state that layers on a certification: only an LICSW holding its Private Independent Practice certification may practice social casework independently as a private contractor.

As an LMSW, generally not for clinical work. NASW's New York chapter says LMSWs "are not allowed to establish a private practice or professional entity" to provide clinical social work services, and New York's education department treats supervisors an LMSW hires or contracts for as "as a general rule, unacceptable."

Who can bill for the work?

Medicare. Medicare Part B covers the services of a clinical social worker, defined in 42 CFR 410.73 as someone with a master's or doctorate in social work, at least two years of supervised clinical social work, and a state license or certification as a clinical social worker. Clinical social workers were added to Medicare by the Omnibus Budget Reconciliation Act of 1989. An LMSW cannot enroll as one. Enrollment runs through PECOS and the CMS-855I; our sister site White Glove Credentialing covers it in how to enroll in Medicare through PECOS.

Commercial insurance and Medicaid. Plan by plan and state by state. Each commercial plan and each state Medicaid program sets its own rules on whether, and through whom, a master's-level clinician's services are paid. See can an LMSW bill insurance?

How do I get from LMSW to LCSW?

Three pieces, in every state with a two-tier system:

1. Supervised clinical experience after the MSW. Commonly 3,000 hours over at least two years with around 100 hours of supervision, but the range is wide: Florida counts 1,500 hours of face-to-face psychotherapy over two years, Michigan wants 4,000 hours for its clinical designation, and Minnesota's LICSW takes 4,000 to 8,000. New York counts 2,000 client contact hours over 36 to 72 months. See supervision hours by state.
2. The ASWB Clinical exam, with board approval first in most states. See exam approval.
3. An application with supervision verification, usually signed by your supervisor on the board's form. See documenting supervision.

Some states require you to hold the master's license while you accrue hours; others, like California, use a registration instead. California has no master's-level license at all; post-MSW social workers register as Associate Clinical Social Workers while they earn hours toward the LCSW.

How far does each license travel?

The clinical license usually travels better, and many endorsement routes look for years of licensed practice; New York's LCSW endorsement asks for at least 10. A master's license that permits only supervised practice is harder to move, because the new state may not have a matching level or may want its own supervision arrangement.

The Social Work Licensure Compact, once it opens, covers both: it has bachelor's, master's and clinical categories. But its rules require the home-state license to authorize independent practice with supervision completed, and a master's license that allows only supervised practice may not qualify. No multistate licenses have been issued yet. See is my LMSW eligible for the compact?

When your hours are done, our LMSW-to-LCSW Clinical License Upgrade (US$299, board and ASWB fees extra) assembles the clinical application, the exam approval and the supervision verifications. See pricing.