Medicare Conversion Factor 1992-2026
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.
Archive of posts filed under the Medicare category.
Where Did The 3.3% Increase In The 2026 Medicare Conversion Factor Come From?
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 …
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2026 Final Medicare Reimbursement for Psychological Services
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 …
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Initial Estimates of 2026 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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Psychotherapy In Medicare – 2013 Through 2023
Copyright © 2025. Gordon I. Herz, PhD. All Rights Reserved.
Total costs of psychological services in Medicare
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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Specialties Opting Out Of Medicare As Of January 2025
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 …
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2025 Reimbursement Top Ten Psychologist Medicare Services
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 …
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Impact of Four Year Phased-In Increase of Work RVUs for Psychological 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 …
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2025 Estimated Reimbursement Top Ten Psychologist Services In Medicare
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) …
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