New Work Values Could Increase Medicare Payment for Psychiatric Codes

The federal Centers for Medicare and Medicaid Services (CMS) last week released the final rule for the Medicare Physician Fee Schedule for 2014. Even more than in past years, the fee schedule rule is a mixed bag of good and bad news for physicians—but the good news for psychiatry is that CMS accepted work values for a number of psychiatric codes (90791/92 and the 908XX codes) that will result in increased Medicare payment for psychiatrists using those codes. The work values, which are recommended by the American Medical Association’s Relative Value Update Committee (RUC), are part of a complex payment formula that includes practice expense and other variables to derive a fee for every code used by physicians.

“CMS has adopted all of the RUC-recommended work values, which means that payment for those codes will go up,” Ronald Burd, M.D., chair of APA’s Committee on RBRVS, Codes, and Reimbursements and APA’s representative to the RUC, told Psychiatric News. “This is the best outcome we could have hoped for at this juncture. There are obviously many, many other items impacting payment. But next time someone asks what APA has done for them, I would point to this as a specific situation where the work of APA, our professional organization, has increased reimbursement for psychiatric care.”

Look for coverage of the final rule in a future issue of Psychiatric News. For further information about CPT coding and the work of the APA committee, see the Psychiatric News article "Psychiatrist’s Coding Expertise Benefits All of His Colleagues."