Tell CMS to properly value psychological testing

[PsyDr]

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CMS is messing around with the RVUs of psych testing, and not in a good way.

APA’s advocacy center has a quick way to send a pre-populated email to CMS that ensures our income.

Students, clinicians, researchers, teachers, family members, etc: Please consider using the link, filling it out, and sharing with anyone who has interests in your income. I usually have my family fill these out too.

News

 

[PikminOC]

CMS is messing around with the RVUs of psych testing, and not in a good way.

APA’s advocacy center has a quick way to send a pre-populated email to CMS that ensures our income.

Students, clinicians, researchers, teachers, family members, etc: Please consider using the link, filling it out, and sharing with anyone who has interests in your income. I usually have my family fill these out too.

News

How exactly are they messing with it? Going from how many rvu to how many?

 

[WisNeuro]

How exactly are they messing with it? Going from how many rvu to how many?

In last year's changes, they lowered the RVU conversion factor, and are planning to lower it again. So, the same RVUs = lowered reimbursements. They raised the RVUs for some codes, but left others as is. Testing codes being one of those they did not raise RVUs for. So, for those patients trying to get their peds patients in for neuropsych testing and confronted with a 18 month waitlist, or 9+ months for adult, wonder no further. There's a reason that the proportion of neuropsychs who do at least partial legal work has been steadily increasing through the years.

 

[PsyDr]

How exactly are they messing with it? Going from how many rvu to how many?

If I am reading this correctly, they are increasing the RVUs for psychotherapy by 19%, and reducing the RVUs for psychological testing by about 15%. This makes no sense, as the overhead, need, and skill level for testing is much higher.


As a physician you may be interested to learn that CMS is also proposing that MFTs, and MAs will now be allowed to own FHQCs. Because that is not going to be an S show.

*edit: wisneuro explained it better.

 

[Sanman]

They have been giving increasing preference to psychotherapy codes the last few years from what I have seen.

 

[MAClinician]

As a physician you may be interested to learn that CMS is also proposing that MFTs, and MAs will now be allowed to own FHQCs. Because that is not going to be an S show.

*edit: wisneuro explained it better.

Where is this indicated/written? Last I heard was only that MA level providers are now being allowed to bill Medicare for behavioral health (so not just psych or LICSW) starting in 2024. I hadn’t heard anything about owning a FQHC 🤔

 

[PsyDr]

Where is this indicated/written? Last I heard was only that MA level providers are now being allowed to bill Medicare for behavioral health (so not just psych or LICSW) starting in 2024. I hadn’t heard anything about owning a FQHC 🤔

What’s the emoji? The actual text was in the link I sent.

Regulations.gov

www.regulations.gov

 

[MAClinician]

The emoji is a thinking emoji, “don’t remember but maybe..” vibe. I found the section in the link. Thank you. That says basically any health professional working at a FQHC can be an owner, interesting.

 

[AcronymAllergy]

Done. And I also don't understand why they would raise psychotherapy codes but lower testing codes. There's probably some political reason I'm not privy to as to why they're trying to disincetivize testing.

 

[Sanman]

Done. And I also don't understand why they would raise psychotherapy codes but lower testing codes. There's probably some political reason I'm not privy to as to why they're trying to disincetivize testing.

There are a lot more parties advocating for psychotherapy codes to be increased than testing codes, IMO. Everyone from LCSWs to NPs has something to gain with the psychotherapy reimbursements. The decrease in well trained assessment folks may sway APA preferences as well. Not sure about the numbers engaging in psychotherapy vs assessment practice.

 

[thebalmofhurtminds]

Done. And I also don't understand why they would raise psychotherapy codes but lower testing codes. There's probably some political reason I'm not privy to as to why they're trying to disincetivize testing.

I could be misremembering, but isn't it because any changes need to be balanced/cancel out? Like if they increase reimbursement on one thing, they have to make up for it elsewhere? I'm sure there's an actual name for it, but it's not coming to me right now.

 

[Sanman]

I could be misremembering, but isn't it because any changes need to be balanced/cancel out? Like if they increase reimbursement on one thing, they have to make up for it elsewhere? I'm sure there's an actual name for it, but it's not coming to me right now.

CMS does have to follow the budget neutrality act and balance out their spending. That said, it can come from anywhere in the CMS budget. I have a few suggestions:

They Lost Their Legs. Doctors and Health Care Giants Profited.

 

[futureapppsy2]

Bumping this because it came up in another thread--it's super quick and easy to do!

 

[WisNeuro]

Also, share with listservs and others.

 

[PsyDr]

Sure would be awesome if a student sent this link to everyone in their cohort.

 

[WisNeuro]

Sure would be awesome if a student sent this link to everyone in their cohort.

Agreed. Unfortunately students seem to be less interested in reimbursement issues, even though it'd further their DEI wants.

 

[futureapppsy2]

Agreed. Unfortunately students seem to be less interested in reimbursement issues, even though it'd further their DEI wants.

IME, many (most?) students have little interest in or knowledge of training and reimbursement issues. I remember mentioning APPIC match my first year, and I got some blank stares (of course, I'm a nerd on SDN, but still...). It's a large part of what leads people to diploma mills and predatory jobs, I think.

 

[WisNeuro]

IME, many (most?) students have little issue or knowledge of training and reimbursement issues. I remember mentioning APPIC match my first year, and I got some blank stares (of course, I'm a nerd on SDN, but still...). It's a large part of what leads people to diploma mills and predatory jobs, I think.

Definitely agree, but I'd hope they'd become doubly interested in it, as it directly affects them, but is also one of the key components underlying most of their advocacy issues.

 

[RxPsych]

Sure would be awesome if a student sent this link to everyone in their cohort.

I sent this link to my DCT (and supervisor) and he forwarded it to the faculty and students! Had quite a few people tell me they filled it out, glad it was taken more seriously than I expected.