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Reimbursement and practice

Working to protect psychologists from Medicare payment cuts

Urging Congress to avoid reimbursement cuts with Medicare’s new evaluation and management service codes

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American Psychological Association. (2020, June 30). Working to protect psychologists from Medicare payment cuts. http://www.apaservices.org/advocacy/news/psychologists-medicare-payment-cuts
Working to protect psychologists from Medicare payment cuts

APA and a broad coalition of healthcare provider organizations have joined together in writing (PDF, 122KB) to Senate Majority Leader Mitch McConnell (R-Ky.), and House Speaker Nancy Pelosi (D-Calif.) to urge that Congress allow the Centers for Medicare and Medicaid Services (CMS) to implement new Medicare evaluation and management (E/M) service codes without imposing reimbursement cuts in other services. Evaluation and management services can only be billed by physicians, and account for roughly 40% of all payments to healthcare providers under Medicare’s fee schedule. CMS will make major changes in its payment methodology for E/M services starting in 2021, and the agency projects the new E/M coding system will result in payment increases. By law, changes that CMS makes in Medicare provider payments must, in the aggregate, be “budget neutral”, meaning that if CMS increases payments for some services it must reduce payments for others. Consequently, CMS projects its E/M code changes would require cutting psychologists’ Medicare reimbursement rates by 7% in 2021, as well as reducing other healthcare providers’ payments.

In a June 18 letter to House and Senate leadership, APA and more than 50 other provider organizations asked that Congress waive Medicare’s budget neutrality requirements for purposes of implementing new E/M codes. This would allow CMS to implement E/M changes without simultaneous cuts. Among the organizations signing the letter were the American Physical Therapy Association, the American College of Surgeons, the American Medical Association, the American College of Radiology, and the National Association of Social Workers.