Clinical Social Workers Call for  Increased Reimbursement Rates

Clinical social workers agree it is past time to increase the work and practice values of the Current Procedural Terminology code set for psychotherapy services, a NASW practice update released in January. said

The CPT codes are a set of medical nomenclature maintained by the American Medical Association that report procedures and services under public and private health insurance programs. They reflect the value of work and practice expenses.

The Centers for Medicare & Medicaid Services reviews requests to resurvey CPT codes during its five-year review process, and NASW sought from members compelling evidence as to why the committees should revalue them.

In response to its inquiry, NASW received more than 200 comments from clinical social workers, all of whom believed that increases in the values were warranted because the last increases were made in the 1990s.

Since that time the provision of psychotherapy services has become more intense, frequent and complex, making them more difficult to provide and requiring even more specialized skill sets and treatment modalities, commenters observed.

“The development of new pharmaceuticals and the need to keep current about the effects of these drugs on patients have required new skills and increased referrals of patients to a psychiatrist for a medication evaluation,” the practice update added.

Clinical social workers also observed a rise in documentation requirements that translates to an augmented workload. Increasingly, insurance companies are requiring additional justification for treatment and paperwork for claim processing, the practice update said.

The use of technology, such as electronic medical records and assessment and intervention tools like video conferencing and online interviewing, also requires clinical social workers to spend resources and devote considerable time to learning how to use the technology.

And finally, the practice update emphasizes that clinical social workers’ role of meeting the needs of their patients takes a toll: “The cumulative impact of listening and bearing witness to the realities of trauma and loss can be stressful to clinical social workers who must keep abreast of new developments in treatment interventions.”

NASW has submitted to CMS the compelling evidence it collected from members to seek permission to resurvey the psychotherapy codes. The association also is collaborating with other professional associations with members who use the psychotherapy codes.

This and other practice updates are available here on the NASW Website.