In November, the Centers for Medicare and Medicaid Services (CMS) released its 2006 Medicare fee schedule, which requires psychologists who provide psychological and neuropsychological testing services to, as of Jan. 1, use an expanded set of testing service Current Procedural Terminology (CPT) codes. The CPT codes are copyrighted by the American Medical Association.
CMS will reimburse the testing codes at a higher rate than the testing codes that were in effect during 2005. Under the new Medicare fee schedule, psychologists will see a 26 to 69 percent increase in average payments for outpatient testing services.
After several years of advocacy by APA's Practice Directorate, CMS agreed to assign "professional work values" to the codes that reflect the psychologist's time, skill and effort in providing psychological and neuropsychological testing services. According to APA Executive Director for Professional Practice Russ Newman, PhD, JD, this change provides greater opportunity for Medicare beneficiaries to get the services they need while also representing a milestone in CMS's increased recognition of the value of psychologists' testing services. By assigning work values to the codes, CMS acknowledges that psychologists are engaged in professional work when providing testing services and increases the level of payment for those services, says Newman. Previously, CMS had declined to include work values for psychological and neuropsychological testing because the agency could not determine what portion of the work was done by psychologists and how much was done by technicians.
Recognizing that CMS's concerns were the main obstacle to obtaining a work value, the Practice Directorate spent several years working closely with the American Medical Association's coding and reimbursement committees to revise the codes. The codes now identify whether the test administration is done by a psychologist, a technician or a computer. In addition, psychologists may use the revised codes to capture the time they spend on interpretation and reporting.
As of Jan. 1, psychologists may no longer use the 2005 CPT codes for psychological assessment, the neurobehavioral status exam or neuropsychological testing. The revised codes must be used for all services furnished on or after Jan. 1.
For more information about the revised code numbers and reimbursement amounts, visit www.APApractice.org.
- Compiled by APA's Practice Directorate