Preparing for the ASWB exam means mastering both the clinical and administrative sides of social work. One often-overlooked ethical topic that shows up on the licensing exam is billing. Section 3.05 of the NASW Code of Ethics is clear: ethical billing isn’t just good practice—it’s a professional responsibility.
The full text of the code:
3.05 Billing
Social workers should establish and maintain billing practices that accurately reflect the nature and extent of services provided and that identify who provided the service in the practice setting.
Accurate billing protects clients, providers, agencies, and insurers—and it’s essential to maintaining trust in the profession. Inaccurate or deceptive billing can lead to serious consequences, including loss of licensure, fines, and criminal charges. But billing ethically isn’t just about avoiding fraud. It’s about transparency, fairness, and respect for the client’s right to understand and trust the financial aspect of care.
Key takeaways for practice—and the exam:
Reflect services accurately. Your documentation and billing must match. If a session was missed, canceled, or brief, billing should reflect that. You can't charge for services that weren’t delivered.
Don’t misrepresent who provided care. If a supervisee or intern delivers services, that must be clearly indicated. It’s unethical to bill under a licensed provider’s name if that person didn’t deliver or properly supervise the session.
Be transparent about fees. Clients have the right to know what services cost, what is covered by insurance, and what they are responsible for paying. Surprises on a bill can erode trust and may violate ethical and legal standards.
Avoid financial exploitation. Recommending unnecessary services, stretching sessions to increase billing, or double-booking clients to maximize revenue all cross ethical lines.
Stay compliant with payer rules. Whether billing through Medicaid, private insurance, or agency funding, social workers must understand the policies and limitations tied to reimbursement. Ignorance is not an excuse.
Supervise ethically. If billing under a licensed clinician’s name for a supervisee’s services, there must be documentation of supervision and oversight. Licensing boards take this very seriously.
Billing issues may feel like “back office” tasks, but they have very real consequences for clients. In many settings, clients are vulnerable not just emotionally—but financially. Ethical billing helps preserve their dignity and safety.
How this topic might appear on the licensing exam:
A social worker at a community clinic reviews client invoices and notices that her name is listed as the provider for several sessions she did not attend or supervise. The sessions were conducted by a graduate-level intern. What is the most ethical response?
A. Contact the billing department to clarify and correct the records immediately.
B. Assuming the intern’s work is covered under her license, let the invoices stand as-is.
C. Request that the intern retroactively document supervision to justify the billing.
D. Leave the billing unchanged unless a client disputes the charges.
This question highlights the need for transparency and accountability. Let’s eliminate incorrect answers. B wrongly assumes the license covers the intern’s independent work—without direct oversight, this may constitute fraud; C suggests covering tracks after the fact, which is not ethically sound; D puts the burden on clients to spot errors they likely won’t see. The best answer is A, which reflects the obligation to ensure billing accurately represents who delivered the service, protecting clients and maintaining ethical practice.
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