Email2Toot Psychology Bot<p>Email2Toot ROBOT -- CHECK ACTUAL AUTHOR BELOW:<br>.<br>.</p><p>TITLE: Declining Psychotherapy Reimbursement in Inflation-Adjusted <br>Dollars & the Inability of Psychotherapists to Collectively Bargain or <br>Really Have Any Power at All in Their Reimbursement</p><p>(Posted for anonymous author by Michael Reeder LCPC -- I did not write <br>it myself but wish I did :) )</p><p>~~~</p><p>My Medicare reimbursement for 45 minutes of psychotherapy in 1990 was <br>$86.82 (in my region -- I have billing records back to 1985, but <br>Medicare did not contract with psychologists until 1990). Currently it <br>is $91.38 (Santa Barbara County), but minus 2% sequestration, it is <br>actually $89.55.</p><p>You can find your region's version by searching 2023 Medicare Physician <br>Fee Schedule (using the name of your state -- and also searching <br>reimbursement rates by year). ____</p><p>Using the US Bureau of Labor Statistic's inflation calculator____</p><p><a href="https://www.bls.gov/data/inflation_calculator.htm" rel="nofollow noopener" target="_blank"><span class="invisible">https://www.</span><span class="ellipsis">bls.gov/data/inflation_calcula</span><span class="invisible">tor.htm</span></a></p><p>which BTW is the most conservative with regard to inflation.</p><p>$86.82 in 1990 had the same buying power as $204.05 today. $89.55 <br>divided by $204.05 equals 44% -- i.e., a pay cut of 56%.____</p><p>In year 2000, in my region Medicare paid $95.89 for 45 minutes of <br>psychotherapy (then coded 90806, now coded 90834). ____</p><p>Using the CPI inflation calculator, $95.89 in year 2000 had the same <br>buying power as $169.89 today. In my region, Medicare currently pays <br>$105.02 for 90834 -- but reduced 2% for sequestration, actually pays <br>$102.92. $102.92 divided by $169.89 = 61%, so only a 39% pay cut. That <br>also tells us that reimbursement dropped 17% between 1990 and year 2000.____</p><p>The biggest impediment to negotiating with insurers is a legal <br>precedent from the late 1970's that prohibits psychotherapists from <br>engaging in collective bargaining. Theoretically under the Sherman Act <br>of 1890, we might form 'trusts' to set fees and control the market.____</p><p>As absurd as this sounds, it has become even more absurd since the <br>advent of managed health care in the 1980's and our ability to <br>participate as Medicare providers in 1990. ____</p><p>Insurers create contracts in which they unilaterally set reimbursement <br>rates, documentation requirements and other working conditions. Although <br>we are all given the same contract, and are thus treated as a class of <br>workers, we are legally prohibited from negotiating contracts as a group <br>of workers.____</p><p>Last week, I wrote (again) to APA's legal team, asking them to <br>prioritize this issue. Historically, professional associations beg off, <br>arguing that they lack the resources to take on trillion dollar a year <br>private insurance corporations, much less the federal government.____</p><p>Please let your professional associations know that the right to <br>collective bargaining is a crucial issue, and in the context of <br>reimbursement that is less than half what it was in 1990, perhaps the <br>criterion issue for the survival of our profession.____</p><p><a href="https://mastodon.clinicians-exchange.org/tags/psychology" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>psychology</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/counseling" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>counseling</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/socialwork" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>socialwork</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/psychotherapy" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>psychotherapy</span></a> <br><span class="h-card"><a href="https://a.gup.pe/u/psychotherapist" class="u-url mention" rel="nofollow noopener" target="_blank">@<span>psychotherapist</span></a></span> <span class="h-card"><a href="https://a.gup.pe/u/psychology" class="u-url mention" rel="nofollow noopener" target="_blank">@<span>psychology</span></a></span> <span class="h-card"><a href="https://a.gup.pe/u/socialpsych" class="u-url mention" rel="nofollow noopener" target="_blank">@<span>socialpsych</span></a></span> <br><span class="h-card"><a href="https://a.gup.pe/u/socialwork" class="u-url mention" rel="nofollow noopener" target="_blank">@<span>socialwork</span></a></span> <a href="https://mastodon.clinicians-exchange.org/tags/union" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>union</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/unionizing" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>unionizing</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/pay" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>pay</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/healthcare" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>healthcare</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/reimbursement" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>reimbursement</span></a> <br><a href="https://mastodon.clinicians-exchange.org/tags/ShermanAct" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>ShermanAct</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/APA" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>APA</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/ACA" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>ACA</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/NCSW" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>NCSW</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/inflation" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>inflation</span></a> <a href="https://mastodon.clinicians-exchange.org/tags/wages" class="mention hashtag" rel="nofollow noopener" target="_blank">#<span>wages</span></a></p>