Medicare Reimbursement & Access
APA and APAPO represent the interests of psychology through ongoing advocacy with Congress and the Centers for Medicare and Medicaid Services (CMS) on issues such as coverage, reimbursement, eligibility and professional status. We work to resolve difficulties encountered by members in providing services to Medicare beneficiaries and obtaining reimbursement through the federal Medicare program. We utilize a multifaceted approach including direct communication with federal policy makers, issuing written comments, attending public forums and conducting outreach to insurance carriers.
- 2012 Medicare Reimbursement Update
After a highly contentious week of political wrangling, Congress passed and President Obama signed legislation (HR 3765) that blocks two key Medicare payment cuts from taking effect on January 1.
- Psychology responds to proposed rule on 2012 Medicare fee schedule
Comment letter raises concerns about elements of proposed rule
- Budget Control Act of 2011 adds pressure to Medicare reimbursement
New law creates a deficit reduction committee widely expected to focus significant attention on Medicare payment
- APA Practice Organization pushes for extension of Medicare psychotherapy payments
Psychology organization gives testimony to House hearing
- Testimony to the Ways & Means Subcommittee on Health, U.S. House of Representatives: September 21, 2011 (PDF, 40KB)
- Comment letter: August 30, 2011
Comments on payment policies under the Medicare Physician Fee Schedule
- Successful advocacy yields changes to CMS publication on mental health
Centers for Medicare and Medicaid Services amends online content after APA Practice voices concerns
- APA Practice Organization supports repeal of Medicare Independent Payment Advisory Board
Letter cites “crushing burden” to psychologists
- APA Practice Organization seeks cosponsors for Medicare "physician" definition bills
If passed, the Medicare "physician" definition bill would ensure that psychologists are able to provide Medicare mental health services free of unnecessary physician supervision requirements
- Psychology gains Medicare physician definition bills
Supporters introduce legislation in the Senate and House that would ensure psychologists are able to provide Medicare mental health services free of unnecessary physician supervision requirements
- Look for delayed psychotherapy payments soon
The restoration payments were one aspect of many Medicare payment changes included in the Patient Protection and Affordable Care Act (PPACA) of March 2010
- Medicare payments reduced for 2011
CMS actions result in lower Medicare reimbursement rates; APAPO continues advocating for practitioners
- New law extends 5 percent psychotherapy restoration and postpones SGR cut
- CMS releases final rule on 2011 Medicare fee schedule
Centers for Medicare and Medicaid Services rule has disproportionately negative impact on mental health reimbursement
- 2011 brings changes to Physician Quality Reporting Initiative
PQRI changes make qualifying for bonus payments easier
- Don’t miss this important December 31 deadline
All Medicare providers must enroll in the Medicare PECOS system by December 31, 2010
- House bill would include psychologists in Medicare “physician” definition
A newly introduced House bill is the first step toward ensuring that licensed psychologists are able to provide Medicare mental health services free of unnecessary and outdated physician supervision requirements
- CMS cautions providers not to resubmit psychotherapy claims
Practitioners who resubmit Medicare claims for psychotherapy services in the hopes of receiving retroactive payments owed them run the risk of having their claims rejected
- Physician definition legislation for psychology introduced
- APA Practice leads fight to halt Medicare MEI cuts
The proposed rule on the 2011 Medicare fee schedule would have a significantly negative impact on psychological and other mental health services
- CMS proposes cuts to mental health services reimbursement
- Pressure needed on Medicare restoration during August Congressional recess
We need your help in August to again prevent cuts to psychologists' Medicare reimbursements for psychotherapy services
- Law postpones SGR payment cut again
The 21.3 percent Sustainable Growth Rate (SGR) cut in Medicare payments has been postponed, retroactive to June 1 and through November 30, 2010
- PQRI to shift from bonus payment to penalty program
Under the new federal health care reform law, the Physician Quality Reporting Initiative (PQRI) becomes a mandatory rather than voluntary Medicare reporting program in 2015.
- June SGR cut blocked by House; awaits Senate vote
Due to a lack of final action, the SGR cut will technically take effect on June 1
- Medicare contractors have June 1 deadline for increasing psychotherapy payments
CMS has announced that the 5 percent Medicare payment restoration for psychotherapy services will take effect on June 1
- Call for members to complete Medicare psychotherapy codes surveys
For the first time in 10 years, Medicare is going to review the value of the work that psychologists and other professionals do in providing psychotherapy services
- Medicare payment cut delayed until June
On April 15, President Obama signed legislation postponing the 21.2 percent Medicare Sustainable Growth Rate (SGR) cut for 2010 retroactive to April 1 through May 31
- Historic law includes psychotherapy payment restoration
The new health care reform law extends the five percent Medicare psychotherapy payment restoration.
- Hundreds of psychology leaders call on Congress
The 2010 State Leadership Conference culminated in over 300 meetings of SLC participants with their members of Congress and Capitol Hill staff for grassroots advocating for professional psychology
- Guidance from CMS on contracting privately to provide Medicare services
Eligible health care professionals, including psychologists, who have never enrolled in Medicare may privately contract to deliver services to beneficiaries without first having to become Medicare providers
- Final Medicare fee schedule rule is a mixed bag for psychology
The Centers for Medicare and Medicaid Services' final rule on the 2010 fee schedule includes decisions regarding Medicare payment for psychologists
- 2010 Medicare payment changes: Questions and answers
Learn how the Centers for Medicare and Medicaid final fee schedule rule affects you
- Final rule on inpatient rehabilitation facilities reflects APA's comments
The rule requires the provision of psychological services as needed and does not limit these services to neuropsychologists only
- APA Supports House Health Care Reform Legislation
- APAPO Responds to Senate's First "Options" Paper on Health Care Reform
- "Descriptions of Policy Options" Released April 29, 2009
- Medicare should acknowledge the evaluation and management services already being provided by clinical psychologists
- Congress should restore Medicare mental health services cuts
- President signs bill postponing SGR cut
