AMA studies “work value” of psychological testing

By Paula Hartman-Stein, Ph.D.

      The arduous process of determining the work values of psychological testing under the Medicare system has at long last begun.

The Relative Update Committee (RUC) of the American Medical Association (AMA) met in early February to examine survey data collected last summer from healthcare provider groups who use the six Current Procedural Terminology (CPT) codes for psychological testing. Personality, neuropsychological, developmental, and aphasia testing were among the services studied. Representatives from six specialty societies, including Psychology, Psychiatry, Pediatrics, Neurology, Social Work, and Speech and Hearing presented their respective survey findings to the RUC.

Jim Georgoulakis, Ph.D. (San Antonio, Texas), the APA representative, stressed that the final outcome directly impacts reimbursement under the Medicare system, but 96% of all third party payors use Medicare rates as a starting point. “How Medicare goes, the rest of the country goes,” said Georgoulakis.

Psychologists completed 400 of the approximately 500 surveys collected, according to Georgoulakis. “At the meeting we had good cooperation with all the specialties, especially Psychiatry,” he said. Due to strict confidentiality rules laid out by the Center for Medicare and Medicaid (CMS) that govern this process, Georgoulakis declined to comment about the specific recommendations from this initial meeting.

Reimbursement for psychological testing under the Medicare system has been lower than that of most other psychological services, including psychotherapy, because of the lack of work values. Psychological testing services are currently paid based only upon practice expenses including malpractice costs and overhead. Work values under the Resource-based relative Value scale (RBRVS) take into consideration technical skill and physical effort, mental effort and judgment, and the stress associated with risk to the patient or others.

The next RUC meeting is slated for the end of April. Final recommendations will go to CMS.