Behavioral health specialists are 59.4% of all clinicians who have opted out of Medicare. 1031 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 have opted …
Continue reading ‘Specialties Opting Out Of Medicare Through 2024’ »
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’ »
In 2023, successful psychology organization advocacy for much-needed increases in the WORK component of the Relative Value Units (RVU) of key behavioral health services (HCPCS psychotherapy codes 90832, 90834, 90837, Health Behavior Assessment and Intervention [HBAI] services, crisis, family, and group therapy services) resulted in CMS’s adoption of an increase of 19.1% in the work …
Continue reading ‘Impact of Four Year Phased-In Increase of Work RVUs for Psychological Services’ »
As I’d surmised, the WORK component of the RVUs of the top three services provided by psychologists in Medicare (HCPCS 90837, 90834, 90832) will increase from 2024 to 2025. So, in the context of a Conversion Factor (CF) that will be reduced by nearly 3% in 2025 relative to 2024, these services (plus one other) …
Continue reading ‘2025 Estimated Reimbursement Top Ten Psychologist Services In Medicare’ »
Well the Final Rule for the 2025 Medicare Physician Fee Schedule (MPFS) dropped into my email Friday about 4:40 pm. Of course they announce this on a Friday evening. The headline – which should be no surprise – is that the Conversion Factor (CF) will be decreasing by 2.83% from its 2024 value, to $32.35. …
Continue reading ‘Medicare 2025 Fee Schedule Initial Reactions’ »
NOTE: Data in the “Annual and Cumulative” chart were updated 8 November 2024, based on the Opt Out Affidavits dataset through September 2024. Other chart data were not updated. 2024 will be (already has been) a record year for the number of psychologists opting out. As of the August 2024 Update to CMS’s Opt Out …
22 July 2024 Source: Herz, G. & OpenAI. (2024). ChatGPT (Version 4.0) [Large language model]. Retrieved from https://www.openai.com/chatgpt. Notes: Enrollment numbers add up to more than 334 million, the estimated U.S. population at the time of this post, due to those with multiple coverage such as Medicare+Medicaid. Adjusting for overlap in coverage, …
As of January 1, 2024, Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) became eligible to bill Medicare independently for their services to diagnose and treat mental illnesses. Expansion to new mental health clinicians in Medicare – with reimbursement at 75% of the physician fee schedule – was thought to be a cost-effective …
As you may have heard, federal legislation taking effect March 9, 2024 for the rest of 2024 included an update to the Medicare Conversion Factor (CF), which will affect reimbursement for Part B services including services provided by psychologists. I previously reported “final” fees that went into effect January 1, based on the CF reported …
I’ve previously written about mental health and other specialties opting out of Medicare. Here’s a look at the number of mental health specialists in Medicare. Data are extracted from https://data.cms.gov/summary-statistics-on-provider-enrollment/medicare-provider-type-reports/cms-program-statistics-medicare-providers. The most recent year for which data are available is 2021. Psychiatry numbers include Geriatric + Neuropsychiatry + Psychiatry specialty designations. Psychology numbers include Clinical …
