Clinical Social Work: Reimbursement

This update is a follow-up to NASW’s Tips and Tools, New Medicare Reimbursement for 2024

On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the 2024 Medicare Physician Fee Schedule (PFS) (CMS–1784–P). The PFS is a listing of fees used by Medicare to reimburse Medicare providers. It addresses changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in health care practices.

NASW members recently informed the association of notices of overpayment from the insurer, Optum/United Behavioral Health, and its Optum Recovery Service Team. An overpayment occurs when an insurer pays more than is expected for a health service.

The National Association of Social Workers (NASW) is participating in a national survey, Clinical Practice Information (CPI), to improve reimbursement rates for clinical social workers.

In July, many NASW members alerted their state chapters to a disturbing and potentially deceptive marketing practice impacting social workers nationwide 

Although Clinic Workers will not be reporting quality measures in 2020 for Medicare, they should familiarize themselves with the Clinical Social Work measure list proposed for clinical social workers.