Copays for Outpatient Psychiatry Services Remain the Same
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA),
which was passed in July over a Presidential veto, mandates the elimination ofthe discriminatory copayment rates for outpatient psychiatric treatment under Medicare. While Medicare has reimbursed for all other outpatient medical
services at 80 percent, with the patient responsible for the other 20, outpatient mental health treatment has only been reimbursed at 50 percent. (Psychiatric evaluations and inpatient psychiatric care have always been paid at the 80 percent rate) The APA lobbied for decades to have this inequity corrected, and it’s efforts were finally rewarded.
It is important to understand, however, that the correction is being phased in
gradually, and that for 2009 the reimbursement rate will continue to be 50
percent. In 2010 and 2011, the rate increases to 55 percent. In 2012, the
reimbursement rate will be 60 percent; in 2013 it will be 65 percent; and, finally, in 2014, it will be the full 80 percent. While this will not affect how much money the treating psychiatrist is reimbursed—that is determined by the fee schedule—it will permit Medicare beneficiaries to receive psychiatric care under the same copayment system that covers their other health care, and this will hopefully encourage more individuals to seek the psychiatric care they need.