Medicare payment method for Psychiatric and preventive services

Psychiatric Services 

Psychiatric services and/or E/M services rendered in an office or outpatient setting, with Interna- tional Classification of Diseases, 9th revision, Clinical Management (ICD-9-CM) diagnosis codes (290-310), are reimbursed at 62.5 percent of the 80 percent Medicare physician fee schedule allowed amount for the service provided. Inpatient psychiatric services are reimbursed at 80 percent of the Medicare physician fee schedule allowed amount.

Preventive Services

Preventive medicine has been addressed by:

* Congress, to insure patient health, thereby reducing Medicare Program expenditures; and

* CMS, to involve physicians in patient care and to enlist their help in educating the public about benefits and coverage policies for preventive immunizations and screenings.

Physicians and healthcare professionals play an important role in utilization of preventive services. A recommendation by a physician is an important influence in determining whether or not beneficiaries decide to be screened. In particular, primary care physicians play a very important role in facilitating compliance with healthcare screenings. Generally, when primary care physicians recommend a screening procedure to patients, patients follow through. Beneficiaries may be unaware of the bene- fits of screening unless their healthcare professionals discuss them and encourage compliance. Phy- sicians should offer screenings according to currently accepted guidelines and should take advantage of every opportunity to recommend preventive care to patients. Reminders should be given at every visit.