APA SERVICES, INC. Current procedure codes area barrier to psychologists participat- ing in integrated care. The current system of identifying medical procedures by using Current Procedural Terminology (CPT) codes, and reimbursement based on those procedures, is delegated to the American Medical Association’s Specialty Society Relative Value Scale Update Committee (RUC) by the Center for Medicare and Medicaid Services. Although integrated healthcare models have been developed and implemented over many years, the CPT codes have never been adapted to enable behavioral health clinicians to provide the wide range of services that are within their scope of practice (APAPO, 2016). The current
CPT system includes explicit codes for Evaluation and Management services restricted to physicians as well as codes in a Psychiatric Collaborative Care Model (CoCM) that are restricted to mental health prescribers such as nurse practitioners, physician assistants and psychiatrists. (Archer et al, 2012). CMS’s longstanding prohibition against psychologists billing for EM services continues to thwart psychologists efforts to fully participate in behavioral health integration (APAPO, 2016). Psychologists are excluded from use of primary care billing codes for providing treatment for obesity and smoking cessation, despite the fact that many of the evidence-based interventions for these conditions were developed by interdisciplinary teams led by psychologists, which indicated behavioral variables as essential for successful treatment. Psychologists and other non-physician providers are also excluded from utilizing reimbursement codes for work which involves supporting communications among integrated care team members. Psychologists are well-trained to provide psychoeducational services to prevent illnesses, as well as overseeing and implementing quality improvement and assessment initiatives.