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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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) …
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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. …
Continue reading ‘Medicare 2025 Fee Schedule Initial Reactions’ »
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 …
