The searchable 2025 Medicare Physician Fee Schedule (MPFS) was published 1/1/2025. Happy New Year?

This is the latest in the year prior to prices going into effect these have been published, though I suppose one could say this is the earliest in the effective year the searchable databse has been provided.

2025 national reimbursement for the ten services most commonly provided by psychologists, plus group therapy, is shown here. Pricing will of course vary based on local geographic adjustments.

The three psychotherapy codes show 2024-2025 increases ranging from .89% (30 minute therapy) to 1.43% (60 minute therapy), due to the second year of the planned phased in 19.1% increase in the WORK component of the RVU for these services. Group therapy will increase by 1.85% for the same reason. These increases are occurring in the context of a 2.83% reduction in the Conversion Factor (CF) from 2024-2025.

The impact of that CF reduction in reimbursement for the other services reported here, in the absence of substantial changes in the RVUs for those services, range from -2.04% (HCPCS 96136, first 30 minutes psychological/neuropsychological test administration and scoring, qualified health professional [QHP]), to -4.65% (HCPCS 96139, technician-administered psych/neuropsych testing beyond initial 30 minutes).

Pricing for 60 minutes of psychotherapy has increased by 9.1% since 2020, an average of 1.82% per year. Compare that to inflation during those years 2020-2025. Psychologists provided 1.44 million of these visits in 2022.

Causes for reduced reimbursement for psychological services provide a roadmap for necessary advocacy, both in Medicare and other public and commercial insurance.

As a reminder, Congress has updated the PFS during the year, five times in the past (2008, 2010, 2012, 2015, and 2024). This remains a possiblity in 2025. “It’s difficult to make predictions, especially about the future” (K. K. Steincke).

For further discussion of this and related issues, you might be interested in my publications this past year:

Medicare reimbursement for psychologists:  Herz, G. I. (2024). Medicare reimbursement for psychologists. Practice Innovations. Advance online publication. https://doi.org/10.1037/pri0000271

Navigating reimbursement for independent practice:  Herz, G. I. (2024). Navigating reimbursement for independent practice. Practice Innovations. Advance online publication. https://doi.org/10.1037/pri0000261

Medicare participation: Considerations for the independent practitioner psychologist: Herz, G. I., & Lepkowsky, C. M. (2024). Medicare participation: Considerations for the independent practitioner psychologist. Practice Innovations. Advance online publication. https://doi.org/10.1037/pri0000254