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The Proposed Updated Physician Fee Schedule 2024: A Positive Impact on Behavioral Health

July 19, 2023 by Daniela Vela Hernandez Leave a Comment

Behavioral health services have become increasingly vital in healthcare, reflecting the growing demand for mental health care providers. To meet this need, significant policy changes and updates have been introduced to improve access to behavioral health services. In this blog post, we’ll explore the new proposed physician fee schedule for 2024 and its potential impact on behavioral health. We’ll focus on provisions that expand the number and type of behavioral health providers, recognize and compensate providers for addressing social determinants of health, and align payment codes across licensed providers to improve health behaviors.

The 2024 proposed physician fee schedule brings several provisions that deeply impact the behavioral health industry. Notably, it allows Marriage and Family Therapists (MFT) and Counselors to directly bill Medicare in integrated settings, including services provided in integrated care settings. Health and Behavior codes will also be billable by MFTs, Counselors, and Social Workers, significantly expanding access to behavioral health services.

Moreover, addiction counselors with credentials matching those of mental health counselors will now be able to bill in integrated care settings, making it easier for individuals with addiction-related challenges to access behavioral health services.

The updated schedule also recommends broadening the scope of crisis coding and places a higher valuation on RVUs for psychotherapy, significantly impacting payment provisions. Additionally, the proposed rule extends the telehealth provision for opioid treatment assessments through 2024, enhancing access to crucial services.

Recognizing the importance of addressing social determinants of health, the updated schedule prioritizes compensating healthcare providers who consider factors like education and housing that substantially influence behavioral health outcomes. This provision encourages providers to improve patient care in these critical areas.

Additionally, the proposed physician schedule explores digital therapies, including digital cognitive-behavioral therapy, to further expand access to behavioral health services beyond traditional settings. This move makes care more accessible and convenient for patients, meeting them where they are.

In conclusion, the proposed updated physician fee schedule for 2024 is set to make positive changes in the behavioral health industry. Its comprehensive provisions aim to expand access to services, compensate providers for addressing social determinants of health, and streamline payment codes for licensed providers. These updates will empower more behavioral health providers to cater to patients’ needs, leading to improved health outcomes. As we move forward, we must continue exploring ways to expand access to behavioral health services and uplift the lives of individuals grappling with mental health challenges.

For more detailed information, you can read the full CMS summary of the proposed rule CMS detail 2024 Physician Fee Schedule. As with any other changes, it is recommended you check with your state regulations prior to making changes in your organization. 

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Category iconIntegrated Care News Tag iconPrimary Care,  behavioral health,  physician fee schedule,  billing,  coding

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About Daniela Vela Hernandez

Daniela Vela Hernandez, LMFT is part of our Technical Assistance team as a Technical Assistance Associate and supports clinics with behavioral health integration implementation and workflow optimization.

Prior to joining the CFHA team, Daniela developed a strong clinical background and experience in multiple settings from community mental health clinics to startup behavioral health. She is passionate about making mental health services accessible to all and is able to use her knowledge of traditional mental health services and integrated behavioral health to support the growth and implementation of integrated care.

Daniela grew up in San Diego, but now resides in little-known Imperial, CA with her husband, two children, and two pups. When not supporting the CFHA mission, Daniela is out rooting for her kiddos on the field.

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