Therapists who accept health insurance submit a bill that includes a code for your visit. 90862 was, for example, a very common code for a medication adjustment visit to a psychiatrist. As of this month, almost all the mental health codes are changing and this is causing a lot of anxiety.
Therapists aren’t sure which code to use and, they aren’t sure how much they’ll be paid. Insurers say the new codes, which are reviewed and set by the American Medical Association, will likely mean lower reimbursement rates for therapists who don’t prescribe drugs. Insurers say they won’t cover some of the codes at all. Many therapists are angry and discouraged.
“The Governor and the President are asking for more emphasis on mental health, but then the coding requirements increase and the reimbursements go down,” says Jonas Goldenberg with the Massachusetts chapter of the National Association of Social Workers.
Psychiatrists may see an improvement in payments for some visits because they’ll be able, for the first time, to bill for medical care they provide while monitoring the effects of medications. But the new codes do not resolve ongoing concerns about whether mental health providers are paid at the same rate as are doctors who deal with physical health. Under the new codes, it does not appear that psychiatrists who evaluate a patient’s physical response to medication will be paid what an internist would to make a similar evaluation.