Thursday, March 28, 2013

APA Members Urged to Register CPT Coding Abuse by Insurers

APA is strongly encouraging its members to inform the Association of any problems of which they are aware stemming insurers' refusal to pay for services in accordance with the new psychiatry CPT codes that went into effect January 1. In an e-mail to members earlier this week, APA stated that "CPT code changes were intended to more accurately reflect the work psychiatrists do and improve patient access to care, but instead have been used as an excuse by some payors to discriminate against psychiatric patients and their psychiatrists in violation of the Mental Health Parity and Addiction Equity Act (2008). The issues differ from state to state and from carrier to carrier. The APA Board of Trustees has committed significant APA resources, both financial and staff, to understand the situation and use all reasonable means, including litigation, to correct the abuses taking place."

To ensure that insurers comply with the law, APA wants members' input as soon as possible so the Association can pursue action with the insurers in question, including filing of lawsuits to force compliance. "APA members must be willing to register their complaints with APA, and a few must be willing to participate as plaintiffs in a lawsuit if one is needed. This would require very little of your time and be at APA's expense," the message explained. Members can register complaints either by completing the form online here or by sending an e-mail to that includes the member's name, location, the insurance company in question, and details about the CPT coding problem. APA and its district branches/state associations have already begun actions against insurers in California, Connecticut, and New York.

Read about the changes to CPT psychiatry codes in Psychiatric News here and here.

(image: Stuart Miles/


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