In an era of strict cost containment, psychologists need information and tools to help maximize their reimbursement and payment for services. The Practice Organization is here to help you navigate the healthcare system with numerous pointers for billing and working with private health insurers and Medicare as well as providing guidance like how to complete the CMS-1500 form.
Qualified Clinical Data Registry
The APA Practice Organization, a companion organization to the American Psychological Association, is planning to develop a qualified clinical data registry (QCDR) for reporting on patient outcomes by psychologists and other behavioral health practitioners. An advisory committee for developing the QCDR is being formed. Further information about the QCDR as well as instructions for submitting nominations (including self-nominations) for the advisory committee can be found in the January 2017 PSA newsletter. The deadline for nominations is Feb. 15, 2017.
Physician Quality Reporting System
Medicare’s Physician Quality Reporting System came to an end on Dec. 31, 2016. Under the Medicare Access & CHIP Reauthorization Act, the Centers for Medicare and Medicaid are required to implement the Merit-Based Incentive Payment System and the use of Advanced Alternative Payment Models to calculate payments to Medicare providers. The transition started in January 2017.
- TRICARE letter from Rep. Tulsi Gabbard to DHA 2018 re: reimbursement rates (PDF, 84KB)
- TRICARE letter from Sen. Jon Tester to DHA 2018 re: reimbursement rates (PDF, 357KB)
- Understanding how Medicare fees are determined
- Who sets psychologists’ payment rates?
- National Correct Coding Initiatives audit
- The RBRVS and the AMA/Specialty Society RVS Update Committee (RUC) Process (PDF, 420KB)
- Information about HIPAA compliance