September 25, 2019
The Centers for Medicare and Medicaid Services (CMS) has proposed two reductions in reimbursement for clinical social workers (CSWs) who are Medicare providers. These proposed cuts include a four percent cut in 2020 for code revisions or a seven percent cut in 2021 to increase reimbursement for evaluation and management (E/M) services which are provided by physicians, nurse practitioners, and physician assistants. The National Association of Social Workers (NASW) strongly opposes these cuts.
The proposed reductions are included in the proposed rule issued by CMS, File Code CMS-1715-P; CY 2020 Revisions to Payment Policies under the Physician Payment Schedule and Other Changes to Part B Payment Policies.
CSWs are already only reimbursed at 75 percent of the physician fee schedule, lower than any other mental health provider in Medicare Part B. NASW’s congressional champions have introduced legislation in the House and Senate to increase this rate to 85 percent.
If CSWs cannot afford to remain in Medicare, then millions of Medicare beneficiaries, including older adults and persons with disabilities, will lose access to essential mental health services. The nation can ill afford to implement these disincentives to CSW participation in this major federal program.
Even if you are not a Medicare provider, it is important to note that private insurance often follows Medicare’s lead when updating payment rates and policies. In other words, this proposal may affect all CSWs.
We urge you to reach out to CMS by Friday, September 27 to make your voice heard. Simply click on the link below to send a pre-completed email to CMS Administrator Seema Verma expressing your opposition to the proposed payment cuts.
NASW has submitted comments on the proposed rule: NASW submits comments to CMS on the CY 2020 Revisions to Payment Policies under the Physician Payment Schedule and Other Changes to Part B Payment Policies (Sept. 24, 2019)
Thank you for your engagement in this critically important advocacy effort. Contact CMS today!