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 [email protected]. 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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