Evidence for Increasing Psychotherapy Fees

Jan 27, 2009

Clinical Social Work Practice Alert

Mirean Coleman, MSW, LICSW, CT
January 2009

Current Procedural Terminology (CPT) Codes for psychotherapy are being considered for review to increase the work and practice expense values associated with reimbursement rates. Work values are based on the time and the required mental effort and judgment to perform a service, and the stress encountered due to the potential risk to the patient. Practice expense values include direct expenses of a clinical practice including clinical labor activities, medical supplies, and equipment. The consideration for review is taking place through the American Medical Association, Relative Value Scale Update Committee and the Health Care Professional Advisory Committee and consists of presenting compelling evidence that psychotherapy codes should be revalued.

NASW would like to hear from clinical social workers who have compelling evidence that work and practice expense values of psychotherapy codes should be increased. Compelling evidence includes, but is not limited to, factors such as

  • Documentation in the literature that psychotherapy has changed
  • Evidence of changes in psychotherapy due to technology
  • Evidence that the patient population and types of problems have changed, resulting in increased work and stress for clinical social workers
  • Flawed methodology used in previous psychotherapy surveys
  • Analysis of data on time and effort measures such as clinical databases
  • Misleading vignettes in previous psychotherapy surveys.
  • An anomalous relationship between the code being valued and other codes.

NASW encourages clinical social workers to participate in the process to validate the need to increase the work and practice expense values of psychotherapy codes. Compelling evidence may be submitted to the following e-mail address, psychotherapysurvey@naswdc.org, no later than February 28, 2009.

Additional information about how reimbursement rates are developed is available at the following Web site:
National Association of Social Workers, www.socialworkers.org. Click on Managed Care Directory. Scroll to Reimbursement Section for practice update,
How Reimbursement Rates are Developed for Clinical Social Workers in Private Practice.”