A number of changes to Medicare were passed in late 2022, including an expansion of the providers who can be reimbursed, an extension of telehealth waivers, and a new conversion factor. You can see an easy-to-read summary of these changes written by APA staff here.
Psychologists now have a mechanism to provide and report interprofessional consultations (through telephone, electronic medical records, etc.) for diagnosis and treatment. The new CPT® codes are 99446–99449 and 99451. We caution you to check with your insurer to see if they reimburse for these codes before billing. You can read more about these new codes on the APA website.
The Increasing Mental Health Options Act (S.669) has been reintroduced in the Senate. As in the last Congress, Senator Sherrod Brown (D-OH) sponsored the legislation along with Susan Collins (R-ME), and is joined this year by new Senator (and past House supporter) Markwayne Mullin (R-OK) and Senator Martin Heinrich (D-CO). The American Psychological Association is working with House supporters on the introduction of companion legislation in that chamber.
The legislation would establish independent practice authority for psychologists treating Medicare patients in outpatient rehabilitation facilities, skilled nursing facilities, partial hospitalization programs, inpatient psychiatric hospitals, and home health agencies. The legislation would also make psychologists eligible for Medicare bonus payments for services delivered in mental health professional shortage areas starting in 2025.
Write your United States senators and ask them to co-sponsor or support S.669.
The federal Consolidated Appropriations Act requires that health plans and insurers verify the demographic information for providers every 90 days. BCBSVT has been sending emails requesting this update/verification to providers this year; you may get similar requests from MVP, Cigna, or other health insurers–IT IS NOT SPAM.
If you are on the BCBSVT panel, you will get an email at the email address you gave BCBSVT at enrollment (or updated email address), and the email will be from noreply@bcbsvt.com. Please check your spam/junk folder for these previous emails and designate that email address as legitimate or “not junk,” depending on your email service.
The email will contain a link to your practice information/provider(s) which will allow you to accept or change the reported data.
For questions about the process or any technical difficulties you have updating or approving your information, you can contact BCBSVT Provider Relations by email at providerrelations@bcbsvt.com or phone them at (888) 449-0443, option 1.
If you have questions about the details related to your information, you will need to contact Provider Files either by email at providerfiles@bcbsvt.com or phone them at (888) 449-0443, option 2.
If you don’t respond to the requests for updated information, you can be removed from the provider directory, and the IRS, HHS, and in some cases your patients can enforce these requirements (usually with a hefty monetary fine).
Providers submitting reconsideration requests to Gainwell Technologies should use the new form that is now located on the Vermont Medicaid website (http://www.vtmedicaid.com/#/forms). This form is to be used for non-timely filing reconsideration requests only; there is a separate form for timely filing reconsideration requests. Effective 4/25/2022, old versions of the Reconsideration Request Form will no longer be accepted and will be returned to the provider.