RCPA - Rehabilitation and Community Providers Association


HGSA Reports: "Psychotherapy is Not Billable 'Incident To'"
December 3, 2002

HGSAdministrators (HGSA), a Medicare Part B intermediary for Pennsylvania, has published its December 2002 Medicare Report, in which it states on page 30 that psychotherapy services are not billable "incident to." HGSA goes on to affirm the five criteria which "incident to" services must meet, however completing the article with the following assertion:

"Psychotherapy is a stand-alone service and is not merely an incidental part of a patient's care; therefore, psychotherapy should not be reported 'incident to' even if the above bulleted items are supported [refers to five criteria mentioned above]."

PCPA continues to work on this issue, which will include a survey of its members to determine the impact of this interpretation on Medicare recipients and providers. The survey is expected to be ready for completion by December 6. Additionally, PCPA is continuing to develop advocacy strategies for this issue.

A copy of the December Medicare Report is available from this link. For more information, contact Rebecca May Cole at the Association.

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