Psychotherapy In Medicare Update – 10 Million+ Sessions Likely Provided For The First Time In 2017

The exact 2017 numbers are not available yet, but it is all but certain that, for the first time, more than 10 million psychotherapy sessions were provided to Medicare beneficiaries in 2017. The 2016 data are available: 9,866,628 therapy sessions were provided that year. Given the rate of increase in recent years, the 10 million annual …

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Update On Brief Session Psychotherapy In Medicare

Brief session psychotherapy showed a 3.9% increase in use in 2016 relative to 2015, the first increase in 3 years, to nearly the same level of use in 2013. 2.13 million brief sessions were provided in 2016. With a National Payment Amount of $64.09 in office settings and $63.73 in facility settings in 2016, a …

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Outliers in Psychotherapy Revisited

ProPublica named names in its recent analysis of “highly unusual billing patterns” for office visits to MDs within Medicare. This reminded me of the 2016 analysis I conducted of billing patterns for 53+ minute psychotherapy sessions. I thought it was time to provide an updated analysis for the most recent data available, 2015. I won’t …

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Psychological and Neuropsychological Testing in Medicare

I’ve previously reported here about provision of psychotherapy to the Medicare population. Another valuable service psychologists and other health professionals provide to those with Medicare is diagnostic psychological and neuropsychological testing. These assessment methods can help clarify diagnoses, formulate treatment plans, measure recovery or progress of conditions, and effects of treatment. To what extent are …

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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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It’s Easy For A Payer To Spot An Outlier

How easy? The following information is based on the 2013 “Medicare Data” (Data.CMS.gov). Can you spot the outliers? That’s right. It’s easy to see that the overwhelming majority of clinicians provided 1000 or fewer 53+ minute sessions in 2013. A few obviously break away from the pack providing 1-2,000 such sessions, fewer still between 2-3,000, …

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45 Minutes is The Most Common Therapy Session Length

53+ minute psychotherapy sessions can hardly be called ‘outlier’ or ‘atypical’ session lengths, as some insurers may now be asserting. However, 53+ minute sessions are not necessarily the most commonly employed increment for treatment visits. Here’s a look at the 2013 numbers from the large Medicare population (approximately 52 million in 2013). Source:  https://data.cms.gov/. *Number of …

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