In an ideal world, value and price would be closely aligned. This alignment doesn’t occur, however, when the value of a service or good isn’t understood. One only has to look at the huge disparity between the salaries of teachers compared with entertainers and sports figures to appreciate this incongruity; or between compensation in the financial-services industry and medicine. For too long, this has especially been the case for psychiatric services. Mental illness is a health care disparity, and mental health care has been stigmatized and undervalued, as have been the physicians who provide it. The result has been inappropriately low reimbursement rates for psychiatric treatment and a corresponding lack of access to mental health care for too many patients.
But now, thanks to the hard work and effective efforts of the volunteer members of APA’s Committee on RBRVS, Codes, and Reimbursement and APA staff, we have strong evidence this situation is changing. Last November, APA won a significant victory on behalf of psychiatrists from the Centers for Medicare and Medicaid Services (CMS), the institution responsible for setting reimbursement values for Medicare coverage.
This victory was possible because of the support psychiatry had from the AMA/Specialty Society’s Relative Value Update Committee (RUC). The RUC, an AMA-convened multispecialty committee of physicians and other professional health care providers that makes recommendations to CMS on the relative value of all medical services, voted to recommend an increase in the work values for all of the most commonly provided psychiatric services. This is the panel of physicians who make recommendations to CMS on the relative value of all medical services by CPT code, so the support of the RUC was a necessary first step. APA members are represented on the RUC by Dr. Ronald Burd, chair of the RBRVS, Codes, and Reimbursement Committee, and Dr. Allan Anderson, a member of the committee.
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