UPDATE 1/1/2022: The American Academy of Sleep Medicine (AAPM) is reporting the same $34.6062 CF I previously reported 12/27/2021. This is now confirmed via the complete PFS (Physician Fee Schedule) at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Carrier-Specific-Files. So, the National Payment Amount (NPA) for the top ten services most frequently provided by psychologists in Medicare will be as follows this year:
| HCPCS | 2022 NPA NON-FACILITY |
2022 NPA FACILITY |
2021 NPA NON-FACILITY |
2022 RVU NON-FACLITY |
2021 RVU NON-FACILITY |
2022 RVU FACILITY |
| 90834 | $102.78 | $90.67 | $103.28 | 2.97 | 2.96 | 2.62 |
| 90837 | $150.88 | $132.89 | $152.48 | 4.36 | 4.37 | 3.84 |
| 90832 | $77.86 | $68.87 | $77.81 | 2.25 | 2.23 | 1.99 |
| 90791 | $178.91 | $154.00 | $180.75 | 5.17 | 5.18 | 4.45 |
| 96137 | $40.49 | $18.69 | $41.87 | 1.17 | 1.2 | 0.54 |
| 96139 | $35.99 | $35.99 | $37.34 | 1.04 | 1.07 | 1.04 |
| 96133 | $102.78 | $79.59 | $103.98 | 2.97 | 2.98 | 2.30 |
| 96132 | $132.54 | $106.93 | $133.29 | 3.83 | 3.82 | 3.09 |
| 90853 | $27.34 | $23.88 | $27.57 | 0.79 | 0.79 | 0.69 |
| 90785 | $14.88 | $13.15 | $15.00 | 0.43 | 0.43 | 0.38 |
Reimbursement will be at the “non-facility” (i.e., office) rate for telehealth until the PHE expires, at which time telehealth pricing will revert to the “non-facility rate” (cf. https://www.apaservices.org/practice/clinic/telehealth-coverage-access). In addition, barring additional congressional action, reimbursement will be reduced by the phased-in return of the “sequester,” by 1% beginning April 1, and by 2% beginning July 1.
Prior post as of 12/27/2021:
This “final” CF value means the Medicare National Payment Amount for 60 minutes of psychotherapy will be $150.88, decreased by 1% from the $152.48 NPA last year. That value of course will vary based on geographic adjustments.If so, this yields a change from the 2021 value ($34.8931) of -0.82%, in contrast to the originally proposed reduction of -3.71%. Yet to be seen in 2022 is the planned phase-in of the “sequester,” which will yield further reimbursement reductions of 1% beginning April 1, and 2% beginning July 1.Medicare’s “conversion factor” (CF) appears to have settled at $34.6062 for 2022. That’s based on drilling down to individual fees reported and apparently updated at NGSMedicare.com’s fee schedule lookup. I have not been able to confirm this via other sources, and have not seen this reported elsewhere.
Assuming no substantial changes in RVUs, a similar pattern will be seen for key psychological procedures.
An additional variable not factored in to this quick update is that Medicare reimbursement will revert to the the “facility” rate – substantially lower than the “non-facility” reimbursed since the beginning of the PHE – for psychological services provided via telehealth.
Here are estimates for how this looks in relation to inflation and past changes in the CF.