Archive of posts filed under the Medicare category.

Impact of Four Year Phased-In Increase of Work RVUs for Psychological Services

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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, and Health Behavior Assessment and Intervention [HBAI] services resulted in CMS’s adoption of an increase of 19.1% in the work RVU, phased in over four …

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2025 Estimated Reimbursement Top Ten Psychologist Services In Medicare

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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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Medicare 2025 Fee Schedule Initial Reactions

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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. …

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Update Medicare Opt-Outs 2024 YTD

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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 …

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MFT And MHC Uptake In Medicare

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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 …

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2024 “Updated Final” Medicare Fees

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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 …

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Mental Health Clinicians in Medicare

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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 …

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2024 Final Medicare Fees

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Relative Value Units (RVUs) became available 12/12/2023 which, along with the 2024 Conversion Factor (CF), allows calculation of the 2024 National Payment Amount (NPA) for all health care procedures reimbursed in Medicare. Here are the NPAs for the top ten services provided by psychologists, with a comparison to 2020-2023. Four services show increases from 2023-2024. …

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2024 Medicare Reimbursement For Psychological Services

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2 November 2023:  The final 2024 Medicare Physician Fee Schedule (PFS) was announced by CMS today, with the final rule to be published in the Federal Register 11/16/23. The final 2024 Conversion Factor (CF) was set at $32.74, a decrease of $1.15 (-3.4%) from the 2023 CF of $33.89. (The proposed rule CF reported in …

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