The Behavioral Medicine Report

As we [American Psychological Association Practice Organization] reported last week, the Centers for Medicare and Medicaid Services (CMS) have announced changes in 2010 to Medicare’s payments for the practice expense portion of numerous services including those commonly billed by psychologists. As you may recall from our July 15 Information Alert, CMS’s proposed rule would have resulted in an expected reduction in Medicare payments for psychological services by an average of 7%. The final rule, published by CMS last Friday, would phase in the reduction over four years, resulting in a lesser immediate impact of an average of 2% for services in 2010.

The chart below projects payment changes for the most commonly billed psychological services.

Average 2010 fees* for the Most Commonly Billed Services:

CPT Code

Descriptor

2009 Average Fee

2010 Average Fee

% Change 2010 v. 2009

90801

Psych. diag. intvw.

$152.92

$153.64

0.47%
———————————————
90806**

45-50 min. outpt. psychtx

$ 89.08

$88.00

-1.21%
———————————————
90818

45-50 mins. inpt. psychtx

$ 85.84

$86.56

0.84%
———————————————
96101

Psych testing by psych

$ 84.40

$82.95

-1.71%
———————————————
96102

Psych testing by tech

$ 51.21

$53.02

3.53%
———————————————
96103

Psych testing by comp.

$ 46.17

$49.77

7.80%
———————————————
96118

Neuropsych testing by psych

$108.20

$100.63

-7.00%
———————————————
96119

Neuropsych testing by tech

$ 74.30

$67.81

-8.74%
———————————————
96120

Neuropsych testing by comp.

$ 68.52

$72.85

6.33%
———————————————
96150

Health/Beh. assmt.

$ 22.72

$22.36

-1.58%
———————————————
96152

Health/Beh. interv.

$ 20.92

$20.56

-1.73%
———————————————
* 2010 fees are based on the 2009 conversion factor and do not reflect the projected SGR cut.

** The 5% restoration for psychotherapy services is not included in these calculations.

For additional information on why CMS is making the change, please see the Information Alert from last Friday, October 30.

Psychologists with any questions about Medicare reimbursement may contact the Government Relations Office by telephone at 202-336-5889 or by email at pracgov@apa.org. CMS lists its complete payment formula and issues affecting the practice expense methodology in the July 13, 2009 Federal Register, Vol. 74, No. 132, on pages 33526-33552.

Jeff Cook, J.D.
Director of Field & State Operations
American Psychological Association Practice Organization

Reprinted with Permission: APA Practice Organization

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