Senate Restores Medicare Psychotherapy Rates until December

Last week Congress halted the so-called Medicare “physician fee cut” that set Part B payment rates for clinical social workers and all independent Medicare outpatient providers with passage of an extension of Medicare physician payments at last year’s level through March 31.  On Wednesday, March 10, the Senate passed a critical extension of these  provisions (H.R. 4213).  Eight Republicans voted with Democrats to defeat a GOP filibuster of this measure. Similar legislation passed the House in December and a conference to reconcile their differences  is now required to enact this legislation.

H.R. 4213 extends the SGR component of the physician fee only through September 30. More importantly for CSWs, the bill retroactively restores a separate five-percent cut that hit Medicare psychotherapy rates on the first of this year. The proposed restoration of Medicare psychotherapy rates would apply to services delivered from January 1, through December 31. Since many private insurance plans pay social workers based on Medicare psychotherapy rates, this will benefit many clinical social workers in private practice.

The new Senate bill also includes a host of provisions unrelated to Medicare, including tax cut extenders and unemployment measures. Federal fiscal relief to help states with their escalating Medicaid expenditures is also included. This provision, called Medicaid FMAP extension, provides $25 billion in emergency Medicaid funds sought by President Obama and supported by NASW.

NASW expects to begin work on new legislation making a long-term correction of Medicare psychotherapy rates as soon as H.R. 4213 is signed into law.

For background on the complex issues involving clinical social fees, see NASW’s advocacy blog posts here.

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