RxP training while on internship available

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edieb

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While on interview for internship in NM, I noticed that many of the interns were already undertaking RxP training before the internship was completed. One started the day after she finished her dissertation.. She said @ this rate she could take the psychology licensing exam and the psychopharm exam in the same week and immediately start her preceptorship to prescribe.

The same phenomenon is occurring in my grad program in LA... many students are enrolling in Farleigh Dickson's (sp?) psychopharm courses for next year scheduled to start the month after they defend their dissertation...

Ppl are saying the job market is so bad for psychologists that this training will make them more competitive for jobs right after licensure as a psychologist.

Intersting that ppl are starting these programs before licensure while on internship; I am surprised that the APA allows this...

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edieb said:
While on interview for internship in NM, I noticed that many of the interns were already undertaking RxP training before the internship was completed. One started the day after she finished her dissertation.. She said @ this rate she could take the psychology licensing exam and the psychopharm exam in the same week and immediately start her preceptorship to prescribe.

The same phenomenon is occurring in my grad program in LA... many students are enrolling in Farleigh Dickson's (sp?) psychopharm courses for next year scheduled to start the month after they defend their dissertation...

Ppl are saying the job market is so bad for psychologists that this training will make them more competitive for jobs right after licensure as a psychologist.

Intersting that ppl are starting these programs before licensure while on internship; I am surprised that the APA allows this...

Is the job market really as bad as people say? (because of the glut of Master's level therapists and PsyDs from degree mills?) What about in CA?
 
edieb said:
While on interview for internship in NM, I noticed that many of the interns were already undertaking RxP training before the internship was completed. One started the day after she finished her dissertation.. She said @ this rate she could take the psychology licensing exam and the psychopharm exam in the same week and immediately start her preceptorship to prescribe.

The same phenomenon is occurring in my grad program in LA... many students are enrolling in Farleigh Dickson's (sp?) psychopharm courses for next year scheduled to start the month after they defend their dissertation...

Ppl are saying the job market is so bad for psychologists that this training will make them more competitive for jobs right after licensure as a psychologist.

Intersting that ppl are starting these programs before licensure while on internship; I am surprised that the APA allows this...

Unless other states get RxP for psychologists, I have a feeling that there will be a glut of prescribing psychologists in NM and LA.

RxP training along with internship or post-doc makes good sense. There is no reason why the didactic portion of training cannot be completed simultaneously, especially since most of the coursework is completed on-line.

Any word on reimbursement for pharmacotherapy services for prescribing/medical psychologists in NM or LA?
 
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positivepsych said:
Is the job market really as bad as people say? (because of the glut of Master's level therapists and PsyDs from degree mills?) What about in CA?

no offense, but there is nothing wrong with psy.d's or master's degree therapists.
 
PublicHealth said:
Unless other states get RxP for psychologists, I have a feeling that there will be a glut of prescribing psychologists in NM and LA.

RxP training along with internship or post-doc makes good sense. There is no reason why the didactic portion of training cannot be completed simultaneously, especially since most of the coursework is completed on-line.

Any word on reimbursement for pharmacotherapy services for prescribing/medical psychologists in NM or LA?

I don’t think there will be an abundance of prescribing psychologists in either NM or LA. At this time, there are approximately 5 psychologists in NM with prescriptive authority, approximately 25 psychologists in LA with prescriptive authority, and 8 or so within the DOD who continue to practice. There are less than 40 psychologists in the US with prescriptive authority. I think this puts things in perspective considering there are around 145,000 APA members.

Not to mention, both NM and LA crank out far more primary care physicians (who prescribe most psychotropics) than prescribing psychologists.

I think NM’s program is live, and not on line. However, I think LA program is on line and takes less time. I heard LA’s program is about 2 years, while NM’s program is about 3-4 years.

Right or wrong, both NM and LA have orals, so they can control the number of psychologists entering the state interested only in RxP to an extent.

In a few months there will likely be another state in the mix, which will take some of the focus off of NM and LA.
 
PsychEval said:


I don’t think there will be an abundance of prescribing psychologists in either NM or LA. At this time, there are approximately 5 psychologists in NM with prescriptive authority, approximately 25 psychologists in LA with prescriptive authority, and 8 or so within the DOD who continue to practice. There are less than 40 psychologists in the US with prescriptive authority. I think this puts things in perspective considering there are around 145,000 APA members.

Not to mention, both NM and LA crank out far more primary care physicians (who prescribe most psychotropics) than prescribing psychologists.

I think NM’s program is live, and not on line. However, I think LA program is on line and takes less time. I heard LA’s program is about 2 years, while NM’s program is about 3-4 years.

Right or wrong, both NM and LA have orals, so they can control the number of psychologists entering the state interested only in RxP to an extent.

In a few months there will likely be another state in the mix, which will take some of the focus off of NM and LA.

All good points.

Which state(s) are you referring to in the last statement? I have heard that GA, HI, and TN were really close during the last legislative sessions.
 
PsychEval said:
I think it will be TN.

BTW, have you seen this?

http://www.nursing.virginia.edu/centers/srmhrc/Psych.htm

There are just not that many psychiatrists in general... If you look at the immigration and residential patterns, most immigrant individuals tend to reside in large metropolitan areas. In my experience, most of the psychiatrists that I encounted are individuals from other countries and in many cases, their command of English is not that great. I'm sure this hasn't been scientifically studied and I'm curious if anybody else has observed the same trend. It appears to me that psychiatrists that have poorer English knowledge tend to prescribe more meds than psychiatrists that have better English knowledge. Has anybody observed this as well? Also, I remember reading somewhere about California's attempt to get rxp; I don't remember their specific legislative actions but it may speed up the timeline of rxp for other states. Does anybody have more information re: this?
 
One of the prescribing psychologists in Louisiana, Dr. Comaty, gave a talk to the clinical psychology graduate students @ LSU yesterday. He said the current numbers were 26 in LA. As a group, >600 scripts have been written without incident. He also commented that all the psychologists who prescribed psychotropics were able to integrate it very well into their private practices.

Although the end result of RxP training is different in NM and LA, the timeline to obtain prescriptive authority is about 3 years (2 years didactics and then preceptorship) for both states. There is a new feature on the Louisiana Psych Assn. website (www.louisianapsychologist.org) that lets you find a psychologist by different criteria -- they just added a new criteria, "medication prescribing." Times are changing
 
edieb said:
One of the prescribing psychologists in Louisiana, Dr. Comaty, gave a talk to the clinical psychology graduate students @ LSU yesterday. He said the current numbers were 26 in LA. As a group, >600 scripts have been written without incident. He also commented that all the psychologists who prescribed psychotropics were able to integrate it very well into their private practices.

Although the end result of RxP training is different in NM and LA, the timeline to obtain prescriptive authority is about 3 years (2 years didactics and then preceptorship) for both states. There is a new feature on the Louisiana Psych Assn. website (www.louisianapsychologist.org) that lets you find a psychologist by different criteria -- they just added a new criteria, "medication prescribing." Times are changing

Did he say anything about reimbursement? Are medical psychologists able to bill for pharmacotherapy services using the same codes as psychiatrists?
 
PublicHealth said:
Did he say anything about reimbursement? Are medical psychologists able to bill for pharmacotherapy services using the same codes as psychiatrists?

He said something about their using the same CPT codes as psychiatrists -- whatever that means.
 
edieb said:
He said something about their using the same CPT codes as psychiatrists -- whatever that means.

I believe that CPT codes are 'universal' billing codes that are used by insurance comapanies to separate types of sessions, e.g. initial psych eval sessions, individual psych sessions, med management, indiv+med management, testing by a technician vs. psychologist, etc. If medical psychologists are using the same codes as psychiatrists for meds, then that means that they are billing the same amount as psychiatrists.
 
doctorpsych said:
I believe that CPT codes are 'universal' billing codes that are used by insurance comapanies to separate types of sessions, e.g. initial psych eval sessions, individual psych sessions, med management, indiv+med management, testing by a technician vs. psychologist, etc. If medical psychologists are using the same codes as psychiatrists for meds, then that means that they are billing the same amount as psychiatrists.

Exactly. CPT stands for "Current Procedural Terminology." Check out this slideshow: http://www.wellmark.com/e_business/provider/Online_Training/CPTPart1.ppt

This is a huge step for psychology -- to be reimbursed at the same rate as psychiatrists. Now let's just hope that the quality and safety of psychopharmacologic care is equal if not better than that provided by psychiatrists. At the very least, patients will get treated sooner, given the shortages of psychiatrists in NM and LA.
 
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doctorpsych said:
I believe that CPT codes are 'universal' billing codes that are used by insurance comapanies to separate types of sessions, e.g. initial psych eval sessions, individual psych sessions, med management, indiv+med management, testing by a technician vs. psychologist, etc. If medical psychologists are using the same codes as psychiatrists for meds, then that means that they are billing the same amount as psychiatrists.


If psychologists are using the same CPT codes as psychiatrists, it does not guarantee the same reimbursement rate. For instance, Psychiatrists, Psychologists, and Social Workers all use a 90801 (Initial Evaluation). However, the reimbursement rates are not usually the same. Additionally, every insurance company is a little different and generalizations don’t apply. For instance, a psychologist may make more money on a 90801 with Blue Cross than a psychiatrist billing a 90801 with medicare. Additionally, if there are 2 providers with the same license using the same CPT code, the one working in an under served area may make more money than the one working in an over served area. It would be interesting to find out the reimbursement rate for a 90862, 90805, and 90807 (respectively - med check, 30 minute psychotherapy with med check, and 50 minute psychotherapy with med check) for both a psychiatrist and a psychologist in the same town with the same insurance company.
 
PsychEval said:
[/B]

If psychologists are using the same CPT codes as psychiatrists, it does not guarantee the same reimbursement rate. For instance, Psychiatrists, Psychologists, and Social Workers all use a 90801 (Initial Evaluation). However, the reimbursement rates are not usually the same. Additionally, every insurance company is a little different and generalizations don’t apply. For instance, a psychologist may make more money on a 90801 with Blue Cross than a psychiatrist billing a 90801 with medicare. Additionally, if there are 2 providers with the same license using the same CPT code, the one working in an under served area may make more money than the one working in an over served area. It would be interesting to find out the reimbursement rate for a 90862, 90805, and 90807 (respectively - med check, 30 minute psychotherapy with med check, and 50 minute psychotherapy with med check) for both a psychiatrist and a psychologist in the same town with the same insurance company.

Good points. I tried but was unable to find John Bolter's e-mail address to ask him these questions. He's one of the medical psychologists in Louisiana. Anyone have his contact information?

Joseph Comaty, another medical psychologist in Louisiana, replied to my e-mail and said that psychologists are using the same CPT codes as physicians, and that they were currently in the process of education insurance companies about medical psychology. He is not currently practicing (he's in mental health administration), so he does not know the current status regarding reimbursement.
 
Here is a prescribing psychologist's e-mail address:

Dr. Elaine Levine (New Mexico)

[email protected]



I could not find Dr. Bolter's email address; however, his office number is one the Louisiana Psychological Assn site:

louisianapsychologist.org
 
PsychEval said:
[/B]

If psychologists are using the same CPT codes as psychiatrists, it does not guarantee the same reimbursement rate. For instance, Psychiatrists, Psychologists, and Social Workers all use a 90801 (Initial Evaluation). However, the reimbursement rates are not usually the same. Additionally, every insurance company is a little different and generalizations don’t apply. For instance, a psychologist may make more money on a 90801 with Blue Cross than a psychiatrist billing a 90801 with medicare. Additionally, if there are 2 providers with the same license using the same CPT code, the one working in an under served area may make more money than the one working in an over served area. It would be interesting to find out the reimbursement rate for a 90862, 90805, and 90807 (respectively - med check, 30 minute psychotherapy with med check, and 50 minute psychotherapy with med check) for both a psychiatrist and a psychologist in the same town with the same insurance company.

yes, you are right, the reimbursement amount is variable between types of licenses (e.g. psychologists, psychiatrists, sw), and also between insurance companies. Although the actual amount of the difference is at times not by much. For example, I practice in a pretty dense large city, one of the insurance companies pays about $90 for 90806 (psychotherapy) for psychiatrists, $80 for psychologists and I think $70 for SW. I wonder if there is a difference between psychiatrists, nurse pract. and PT's among med check sessions?
 
thought I would revive this as I am currently beginning to apply for internship 2009-2010 year. Any new programs that allow the interns to begin RxP training?
 
the APA does not currrently approve psychopharm training programs. although i imagine they might in the future.


FDU's website says students have to have a license before matriculation.

Nova will allow advanced standing students.

I belive that there are some non-masters programs that one could undergo in some internship sites, depending on your loan structure, vacation days, supervisor, etc. I sincerely doubt someone could do the program at Nova while on internship, as the required times at the university would exceed the vacation days at normal internships.
 
Nova will allow advanced standing students.

I sincerely doubt someone could do the program at Nova while on internship, as the required times at the university would exceed the vacation days at normal internships.

It definitely would be a challenge, as it is fully campus-based and there is a pretty significant amount of studying you need to do in between sessions, particularly for the pharmacology-intensive classes. It would be pretty overwhelming to do during the internship year because of the travel required, since they are (supposedly) changing the format to FRI/SAT/SUN once a month, for 2 years.

I was able to take classes during my 3rd, 4th, and part of my 5th year (I skipped some classes because of research deadlines and clinical commitments), though our format was 6 days at a time, every other month. I am local so it was a bit easier and I had good access to some of the professors, so I made it work.

I believe the degree cannot be conferred until you are licensed, so there really isn't a rush per se. I still have a couple classes and the practicums that I'm spreading out over the next couple of years.
 
what does Nova mean by "advanced standing students?" When are you considered advanced standing?
 
thought I would revive this as I am currently beginning to apply for internship 2009-2010 year. Any new programs that allow the interns to begin RxP training?

Hey, Bella,

Are you planning on moving to one of the two states after internship so you can start prescribing/building a practice or do you just want the training for training's sake?
 
^currently training's sake. I would like to Rx someday definitely. I am hoping to move to Cali and crossing my fingers that they pass the bill there.
 
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