How Much Do Psychologists Charge?

It’s been a while since I reported about this. Given that hospitals and now insurance companies are required to publicly report their charges including cash prices for uninsured consumers and negotiated reimbursement, and especially in the context of current needs for access and care, maybe it’s time for mental health clinicians to increase transparency. What …

Continue reading ‘How Much Do Psychologists Charge?’ »

Neuro/Psychological Testing Services In Medicare – Initial Look At The First Pandemic Year

Diagnostic neuropsychological and psychological testing are predominantly psychologist-performed services in Medicare. The following provides an initial look at these services by psychologists and other health professionals in 2020 – the first year of the pandemic – based on data that have recently become available through CMS*. Seventeen diagnostic testing/evaluation services were available to psychologists in …

Continue reading ‘Neuro/Psychological Testing Services In Medicare – Initial Look At The First Pandemic Year’ »

Psychotherapy In Medicare Update – Initial Look At The First Pandemic Year

Public use data have recently become available through CMS, allowing initial looks at practice patterns during the first year of the pandemic. 2020 may have been a banner year for a shift to telehealth, but the increased flexibilities do not seem to have yielded increased provision of psychotherapy overall to the Medicare population. Indeed, an …

Continue reading ‘Psychotherapy In Medicare Update – Initial Look At The First Pandemic Year’ »

2022 Medicare Conversion Factor “Final” – Quick Update

UPDATE 1/1/2022: The American Academy of Sleep Medicine (AAPM) is reporting the same $34.6062 CF I previously reported 12/27/2021. This is now confirmed via the complete PFS (Physician Fee Schedule) at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Carrier-Specific-Files. So, the National Payment Amount (NPA) for the top ten services most frequently provided by psychologists in Medicare will be as follows this …

Continue reading ‘2022 Medicare Conversion Factor “Final” – Quick Update’ »

Reimbursement Estimates For Psychological Services In Medicare 2022

November 26, 2021 Update: Clinical Psychologist (and Physician) and Social Worker Fee schedule, Medicare in Wisconsin, 2022. Source:  https://www.ngsmedicare.com/web/ngs/fee-schedule-lookup?lob=96664&state=97006&region=93624 National Government Services, Inc. – Wisconsin (00) 2022 Clinical Psych & Social Worker Fee Schedule CODE CP FEE CP FAC FEE (#) CSW 75% FEE CSW 75% FAC FEE (#) EFFECTIVE DATE 90785 $14.04 $12.45 $10.53 …

Continue reading ‘Reimbursement Estimates For Psychological Services In Medicare 2022’ »

2021 Update – Psychotherapy In Medicare

As with prior updates (e.g., 2019 and 2018, CMS data releases related to utilization tend to be 2 years behind the year of service provision. Data for services in 2019 became available at the end of August 2021, at Data.CMS.gov. The following analyses are for individual therapy sessions only (HCPCS 90832, 90834, and 90837). Psychotherapy plus medication, …

Continue reading ‘2021 Update – Psychotherapy In Medicare’ »

Update – Psychotherapy in Medicare

I have previously reported about provision of psychotherapy in Medicare, most recently in 2019 and 2018. CMS data releases related to utilization are always at least 2 years behind the year of service provision. Data for services in 2018 became available early in February 2021, and the following analyses are based on those data, available …

Continue reading ‘Update – Psychotherapy in Medicare’ »

Update #3 Medicare 2021 – “Final” Reimbursement For Psychological Services

With the passage of the Consolidated Appropriations Act December 21, 2020, signed into law six days later, the Medicare Physicians Fee Schedule received an unexpected pardon from the planned, unprecedented 10.2% reduction in the Conversion Factor governing all fees. Instead, the CF was increased from 32.4085 to 34.8931. An additional $3 Billion was allocated to …

Continue reading ‘Update #3 Medicare 2021 – “Final” Reimbursement For Psychological Services’ »

2021 Medicare Prices For Psychological Services

“NPA” = “National Payment Amount.” This will vary based on your geographic region. “RVU” = “Relative Value Unit.” This value is the total of the Work, Practice Expense (PE), and Malpractice components that make up every procedure that Medicare pays for. RVUs used to be objectively determined, but the process to determine these has become …

Continue reading ‘2021 Medicare Prices For Psychological Services’ »

Beware of Success

Historically, the “overhead” component (practice expense, PE) of the formula for pricing psychotherapy in Medicare has averaged 21% from 2000 to 2020. As a reminder, the national price of a service in Medicare is determined by three components, work, practice expense, and malpractice, which are then moderated by geographic location to produce the local values. …

Continue reading ‘Beware of Success’ »