December 13, 2013

Medicare Psych Rates Increase

By admin

Medicare announced rate increases for mental health services this week.

As CMS reports, “The 2014 payment rates increase payments for many medical specialties with some of the greatest increases going to providers of mental health services including psychiatry, clinical psychologists and clinical social workers.” Psychologists are listed as having the second largest boost for 2014, with a combined increase across all billed services of approximately 8 percent.

“Some of the greatest increases [for 2014 Medicare payment rates] go to providers of mental health services including… clinical psychologists.” ~ Centers for Medicare and Medicaid Services, 11/27/13

The largest increases will be for neuro-psychological testing.  There were a few codes that the rates were reduced including an initial evaluation, the 90791 which was reduced by 15.5%.

Testing Codes a Mixed Bag
Beyond the psychotherapy codes, psychologists will see additional gains but also some losses for other services. On the plus side there will be an increase to the health and behavior codes (96150 – 96155) of approximately 1.5 percent. The testing and assessment codes, however, will vary with some paying more and others paying less.

The largest increases will be for neuro-psychological testing (+3 percent for 96118) and neuro-psychological testing by a technician (+4 percent for 96119). The largest decreases pertain to the two codes for testing by computer, with a loss of 38 percent for 96103 and 55 percent for 96120. Psychological testing by a technician (96102) will lose 28 percent while psychological testing (96101) will decline by 7 percent. Losses to the testing codes are due to changes by CMS in the practice expense component of Medicare payment.

According to the APA the following are estimates of the approximate change to individual codes:

Code

Percent Increase/Decrease

Psychiatric diagnostic evaluation (90791)

-15.5

30-minute psychotherapy (90832)

-1.5

45-minute psychotherapy (90834)

+1.5

60-minute psychotherapy (90837)

+3.5

Psychoanalysis (90845)

+17

Family psychotherapy w/o patient (90846)

+34

Family psychotherapy w/ patient (90847)

+15.5

Multiple family group psychotherapy (90849)

-4

Group psychotherapy (90853)

+3

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