Starting Jan. 1, all mental health providers must use new CPT® code numbers for psychotherapy when billing Medicare and all insurance carriers. The changes in store for 2013 involve only the psychotherapy family of codes — the codes found in the psychiatry section of the 2013 CPT manual. Other codes used by psychologists, such as neuropsychological and psychological testing as well as health and behavior codes, will not change.
The psychotherapy code changes resulted from the five-year-review process required of the Centers for Medicare and Medicaid Services (CMS). The national associations representing psychology, psychiatry, social work and nursing participated in a confidential and proprietary process overseen by the American Medical Association (AMA) as an integral part of the CMS review process.
Representatives of the mental health provider associations took part in a year-long workgroup involved in evaluating the definitions of existing codes related to psychotherapy and recommending relative value units (RVUs) that CMS will consider in determining Medicare reimbursement rates for psychotherapy services beginning in 2013. Along with the other associations involved in the workgroup, the APA Practice Organization (APAPO) conducted a member survey during the spring of 2012 as part of the process of determining recommended RVUs for the psychotherapy codes that take effect on Jan. 1.
Information about Medicare payment rates associated with the new codes is expected to be released in November when CMS publishes the final Medicare fee schedule for 2013.
APAPO has been providing members with information and resources to help practitioners prepare for using the new codes on Jan. 1. Visit the billing and coding section of APAPO's Practice Central website to access the online compilation of resources.
And look for the December issue of Monitor for an insert from APAPO with information about the 2013 psychotherapy codes.