I last reported about specialties opting out of Medicare in November 2023. As of September of that year, 31,603 had opted out, a 7.8% increase over January 2023. Almost 14,000 mental health clinicians had opted out, about 5500 of whom were psychologists, the single largest group opting out. Nurse Practitioners showed the largest increase (~8%) …
“Americans always do the right thing, after trying everything else.” — Churchill? “A budget is a moral document.” — They A lot of countries have figured out how to provide universal health care.Q: Why can’t the U.S. figure this out? A: Follow the money. A few people (companies) are making a lot of money inserting …
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A reversal after five years of reducing the CF. Where the CF would be relative to its 1992 value if it had kept up with inflation.
Most of it came from H.R.1, a.k.a. Public Law No: 119-21, the “One Big Beautiful Bill Act.” H.R.1 became law 7/4/2025. I previously reported final 2026 national payment amounts (NPA) for the ten services most commonly provided by psychologists, and group therapy, based on the Final Rule for the Physician Fee Schedule (PFS). The Final …
Continue reading ‘Where Did The 3.3% Increase In The 2026 Medicare Conversion Factor Come From?’ »
HCPCS 2025 National Payment Amount (NPA) 2026 Estimated NPA (7/16/2025) 2026 Final Change 2025-2026 90837 $154.29 $167.10 $167.00 8.2% 90834 $104.16 $113.97 $113.89 9.3% 90832 $78.93 $85.89 $85.84 8.8% 90791 $166.91 $173.45 $173.35 3.9% 96139 $33.64 $35.76 $35.40 5.2% 96133 $93.48 $98.26 $97.86 4.7% 96137 $35.90 $37.10 $37.07 3.3% 96132 $125.18 $122.65 $122.24 -2.3% 90785 …
Continue reading ‘2026 Final Medicare Reimbursement for Psychological Services’ »
The 2026 Proposed Rule for payment policies under the Physician Fee Schedule was published 7/16/2025, opening up a comment period until 9/12/2025. Quick review of the proposed rule shows a projected Conversion Factor (CF) of 33.4209, amounting to a 3.3% increase over the 2025 CF of 32.3465, taking into account several adjustment factors. The CF …
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Copyright © 2025. Gordon I. Herz, PhD. All Rights Reserved.
Working on an ezine type post this morning, I was able to do some quick calculations on the total cost of psychological services in Medicare. Here’s a quick look. 2024 Projected Allowed Charges (Millions)¹ 2024 Percent of Medicare Outlays² 2024 Percent of Total Mandatory Outlays Clinical Psychologists $717 .08% .017% Clinical Social Workers $801 .09% .02% …
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Nearly 60% of clinicians who have opted out of Medicare are behavioral health specialists. 1,031 psychologists opted out in 2024, the most ever in a single year, a 34% increase over 2023. Mental Health Counselors (MHC) and Marriage and Family Therapists (MFT) became the third and fourth most numerous of the specialties to …
Continue reading ‘Specialties Opting Out Of Medicare As Of January 2025’ »
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 …
Continue reading ‘2025 Reimbursement Top Ten Psychologist Medicare Services’ »
