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 …
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. …
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 …
Continue reading ‘2024 Medicare Reimbursement For Psychological Services’ »
I first reported about mental health fees in 2013, and then again last year. The following update is based on all charges submitted to Medicare for these services in 2021 by psychiatrists, psychologists and social workers. In theory, charges to patients who have Medicare are likely to be the same as or very similar to …
Continue reading ‘How Much Do Therapists Charge? – 2023 Update’ »
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 …
The following are prices listed for the six behavioral health services required to be provided by hospitals in a consumer-friendly “shoppable services” search. Prices were retrieved 15 January 2022 on review of these three hospitals and related locations. Location Service SSMHealth St. Mary’s UnityPoint Health Meriter UW 30 Minute Therapy NF PC $154 45 Minute …
In August 2021 I reviewed Madison hospitals’ compliance with the Federal “Hospital Price Transparency Final Rule,” which requires hospitals to make their standard charges readily available to the public, in both “consumer-friendly” and “machine-readable” formats. Hospitals have now had an additional five months to come into compliance, and it’s time for an update to see …
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’ »
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®ion=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’ »
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’ »
