HOW ARE MENTAL HEALTH SERVICES TO OLDER ADULTS REIMBURSED?
American Psychological Association
Table of Contents
Why Practitioners Need Information
- Directly or indirectly, most mental health services to older adults are reimbursed through one or more sources of public funding, notably Medicare, Medicaid, and the U.S. Department of Veterans Affairs. Local, county, and state initiatives exist in some parts of the country to enhance the scope or quality of mental health services to older people. Some older people purchase additional private insurance, typically to supplement Medicare reimbursement, and others are dually eligible for Medicare, Medicaid, or veterans' benefits.
- In 1987 psychologists (as well as social workers) were designated as Medicare providers, which has enabled psychologists to provide fee-for-service assessment and treatment to older adults. Under this arrangement most services are reimbursed at 50 percent of fees established by Medicare.
- Since the designation of psychologists as Medicare providers, there has been considerable expansion of mental health services into nursing homes and other residential facilities. While provision of psychological services to this population is a welcome development, reimbursement of these services has recently come under sharp scrutiny by Medicare, which has raised questions about the appropriateness of some of the services that have been delivered.
- Increasing numbers of older people are entering managed care delivery systems, including health maintenance organizations (HMOs). HMOs provide the potential for better integrated systems of care than exist in many sectors, yet there is ongoing concern about the level of mental health services that are available within them, especially to those older persons with chronic and persistent mental illness.
