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 $9.34
01/01/2022
90791 $168.51 $145.72 $126.38 $109.29
01/01/2022
90832 $73.01 $64.78 $54.76 $48.59
01/01/2022
90834 $96.41 $85.33 $72.31 $64.00
01/01/2022
90837 $142.05 $125.60 $106.54 $94.20
01/01/2022
90839 $135.47 $120.28 $101.60 $90.21
01/01/2022
90840 $66.37 $59.40 $49.78 $44.55
01/01/2022
90845 $91.07 $81.26 $68.30 $60.95
01/01/2022
90846 $92.61 $91.98 $69.46 $68.99
01/01/2022
90847 $95.97 $95.65 $71.98 $71.74
01/01/2022
90849 $33.00 $26.67 $24.75 $20.00
01/01/2022
90853 $25.72 $22.55 $19.29 $16.91
01/01/2022
90880 $100.43 $85.24 $75.32 $63.93
01/01/2022
# = this amount applies when service is performed in a FACILITY setting

 

2022 Fee Schedule Clinical Psychologist, Top Ten Psychologist Utilization (2019)

HCPCS 2022 ACTUAL WISCONSIN 2022 ESTIMATED NATIONAL 2021 WISCONSIN
CHANGE WI 2021-2022
90834 $96.41 $99.43 $99.80 -3.40%
90837 $142.05 $146.79 $147.41 -3.64%
90832 $73.01 $74.91 $75.61 -3.44%
90791 $168.51 $174.00 $174.88 -3.64%
96137 $37.49 $40.31 $39.92 -6.09%
96139 $32.70 $35.94 $34.95 -6.44%
96133 $96.08 $110.10 $100.57 -4.46%
96132 $123.82 $128.31 $128.49 -3.63%
90853 $25.72 $26.54 $26.71 -3.71%
90785 $14.04 $14.44 $14.58 -3.70%

 

Fee schedule availability for your jurisdiction (Medicare Administrative Contractor)

AVAILABLE URL
CGS YES
FSCO YES
NGS YES
NORIDIAN YES
NOVITAS YES
PALMETTO NO
WPS YES

 

November 18, 2021:  Here are estimates of the National Payment Amounts in Medicare for 2022 for the top 10 most frequently billed psychologist services, based on 2019 utilization. The estimates assume (1) no change between now and implementation in the 2022 “final rule” Conversion Factor (CF) of $33.59, decreased by 3.7% from the 2021 value of $34,89, and (2) no changes in the RVUs for these procedures from 2021.

HCPCS 2022 2021
90834 $99.43 $103.28
90837 $146.79 $152.48
90832 $74.91 $77.81
90791 $174.00 $180.75
96137 $40.31 $41.87
96139 $35.94 $37.34
96133 $100.10 $103.98
96132 $128.31 $133.29
90853 $26.54 $27.57
90785 $14.44 $15.00

Leave a Reply

Your email address will not be published. Required fields are marked *

6 − 6 =

This site uses Akismet to reduce spam. Learn how your comment data is processed.