Update: Mental Health Clinician Flight from Medicare Fails to Materialize

Dire warnings of wholesale flight of mental clinicians from the Medicare system, with complaints of low and declining reimbursement, and increasing documentation and measurement burdens, did not materialize, at least from 2012 to 2014. 2015 data became available earlier this year from CMS. Here is what the continued pattern looks like. Two percent fewer psychiatrists …

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Brief Session Psychotherapy In The Medicare Population

In the Medicare population, psychotherapy is most commonly provided in 45 minute sessions (90834, technically, 38 to 52 minutes in length). Sessions of 53+ minute length (90837) are the second most frequently provided. When the 53+ minute code first became available in 2013, many mental health professionals raised alarms about whether this session length would …

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Changes in Psychotherapy Service Delivery in Medicare 2013 – 2015 – Part 2

Newly available data show that the number of 53+ minute sessions (CPT code 90837) provided to Medicare beneficiaries increased by 48% from 2013 to 2015, to nearly 3.2 million of these sessions. Estimated Medicare payments for these sessions nearly doubled in that same period, to more than $263 million. The increase in total payments is not …

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Changes in Psychotherapy Service Delivery in Medicare 2013 – 2015 – Part 1

In the context of recent reports that Medicare abruptly halted release of much-anticipated data which could have shed light on the performance of Medicare Advantage plans, CMS recently made available its “public use file” on “Provider Utilization and Payment Data” for 2015. Data provide a resource to better understand individual and aggregate delivery of health …

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The Left’s Convenient Hypocrisy on Obamacare

First, lest my point here be misinterpreted as a condemnation of the Affordable Care Act, let me state emphatically and unequivocally that I support the ACA. Let me take that back just a bit. I support it with all the enthusiasm that any of its strongest supporters do. That is, it is the best system …

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Cognitive Assessment in Private Practice

Thank you Dr. Tansey for inviting me to talk to your graduate Adult Cognitive Assessment class on assessment in private practice. I thoroughly enjoy talking with the “next generation” of our profession. This was an interested group who asked great questions and are clearly thinking about how they will fit in the future. I hope …

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Are Mental Health Clinicians Fleeing Medicare?

As a followup to recent “sky is falling” levels of concern about potential large scale flights of practitioners from Medicare, I got curious about how many mental health clinicians provide services to Medicare beneficiaries, and what the recent trends have been. The “provider utilization and payment data” published by CMS at Data.CMS.gov afford an opportunity to …

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OMG The Sky Is Crashing In On Us Again!!

How quickly we forget. Just a year ago, every health care practitioner participating in Medicare (on average less than 1% of physicians have opted out of Medicare — though of course now we are hearing scare stories of pending “mass exodus”) the annual “will they or won’t they really impose the 25% or so ‘sustainable growth rate’?” …

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