“NPA” = “National Payment Amount.” This will vary based on your geographic region.

“RVU” = “Relative Value Unit.” This value is the total of the Work, Practice Expense (PE), and Malpractice components that make up every procedure that Medicare pays for. RVUs used to be objectively determined, but the process to determine these has become highly politicized (what hasn’t?) sometimes causing competition among medical specialties and health care professions. In 2021, specific efforts were made to increase the payment amount for primary care physicians. This caused a corresponding reduction in the amount available to be paid to other health care professionals.

The RVU is multiplied by the “Conversion Factor” to determine the Medicare NPA. That will be modified by a geographic adjustment depending on where the doctor practices.

The Conversion Factor decreased by 10.2% from 2020 to 2021 (36.09 in 2020, 32.41 in 2021). This is the largest reduction ever, reducing the CF to below the 1994 amount (32.91).

The “Top 10” procedures were determined based on the number of units billed by psychologists to Medicare in 2017, the most recent year for which data are currently available.