Medicare Reimbursement for Mental Health Services

The following graphs show the changes in Medicare reimbursement for therapy, initial diagnostic interview, and neuropsychological testing from 2001 to 2013. Values are for reimbursement for the Medicare Administrative Contractor (MAC) covering portions of the Midwest (IA, IL, IN, KS, MI, MN, MO, NE, and WI). Actual amounts will vary in different regions of the country due to geographic practice cost indices (GPCI), however the general trends over time and yearly variations will follow the same direction and rate of change. The red lines show actual reimbursement rates. The green lines show how rates would have changed if the 2001 reimbursement value had grown at the pace of inflation, i.e., the rate at which costs required to provide these services grew. The 2013 values show what will happen unless Congress fixes the “Fiscal Cliff” that will hit Medicare rates due to the Sustainable Growth Rate (SGR) which will go into effect 1/1/2013.

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