Beware of Success

Historically, the “overhead” component (practice expense, PE) of the formula for pricing psychotherapy in Medicare has averaged 21% from 2000 to 2020. As a reminder, the national price of a service in Medicare is determined by three components, work, practice expense, and malpractice, which are then moderated by geographic location to produce the local values. …

Continue reading ‘Beware of Success’ »

Update: Medicare National Values For Health and Behavior Assessment and Treatment Procedures

For interested readers, I’ve been able to extract the Medicare National Payment Amounts for the Health and Behavior (H&B) codes in 2020. An Assessment or Re-Assessment (96156) will be valued at $99.97. Sixty minutes of Individual Intervention (96158 + 2 x 96159) will be valued at $115.85. These are the National values, without geographic price …

Continue reading ‘Update: Medicare National Values For Health and Behavior Assessment and Treatment Procedures’ »

Pay raise for psychologists?

Psychologists were recently apprised of a “huge win” in advocacy in relation to Medicare, resulting in “rate increases (which) are strong evidence that CMS recognizes the importance of addressing the psychological factors that affect patients’ physical health problems (and) will make it financially more sustainable for psychologists to provide HBAI [health and behavior] services and …

Continue reading ‘Pay raise for psychologists?’ »

The Medicare Opt Out Rate is Decreasing Among Mental Health Clinicians

Despite a flattening of reimbursement rates and other concerns about mental health care in Medicare, not only is the feared and/or believed flight of mental health clinicians from Medicare not occurring, but the the actual trend is clearly in the opposite direction. The number of mental health clinicians opting out of Medicare has reached its …

Continue reading ‘The Medicare Opt Out Rate is Decreasing Among Mental Health Clinicians’ »

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 …

Continue reading ‘The Left’s Convenient Hypocrisy on Obamacare’ »