Advocacy Corner

Advocacy matters because it works! Below are updates from previous advocacy action alerts or Advocacy Corners, as well as more opportunities for federal advocacy for our profession and patients.

Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule Update: 

1. CMS will increase the work values used in calculating payments for both psychotherapy and H/B assessment and intervention codes by 19% over a 4 year period.
2. CMS will continue reimbursing telehealth provided to patient homes at the higher non-facility rate in 2024. CMS will continue to allow for psychological/neuropsychological assessment via telehealth through 2024.
3. CMS finalized coding and payment for two new codes that can be used by psychologists: Social Determinants of Health Risk Assessment and Principle Illness Navigation, both to be billed alongside the CPT code for the visit. The former is for review of patient social risk factors impacting diagnosis and treatment and the latter is for services to support treatment navigation for patients and families with high-risk medical and behavioral health conditions. Originally these codes were designed for physicians only, but advocacy got us access!
4. CMS finalized active payment status for CPT codes 96202/96203: multiple-family group behavior management/modification training for guardians/caregivers of patients with a mental or physical health diagnosis.

Youth Mental Health Research Act Update: 

This summer there was an initiative that requested Congress to authorize $100 million per year for 5 years for a collaboration of the National Institute of Mental Health (NIMH), National Institute on Minority Health and Health Disparities (NIMHD), and the National Institute of Child Health and Human Development (NICHD) to develop research to guide the long-term recovery and resilience of youth, reduce health disparities, and improve treatments delivered to youth in crisis. This has now become filed legislation in both the House (HR 5976) and the Senate (S 3060), which moves it one step closer from being a good idea to becoming a law. It would still benefit from reaching out to your Representative and Senators to ask them to cosponsor it if they have not yet. This legislation would be the first recent major investment in mental health research, rather than in services.

Opportunities: 

Since Congress has decided to stay open (yay!), they are now working on the budget, which includes deciding funding for programs. Thus, many programs for mental health and psychology need advocacy to help ensure they are not cut, and rather funded at the highest levels possible. The APA Advocacy Summit that was held earlier this month focused on this.  But, more advocacy is needed. Reach out to your Representative and Senators to ask them to allocate the maximum possible funding levels for Fiscal Year 2024 for any of the following (you do not have to discuss all, just pick a favorite):

Psychology Workforce Development Programs

• HRSA’s Graduate Psychology Education (GPE) Program supports the education and training of doctoral-level health service psychologists. As the demand for mental and behavioral health services continues to outpace the available workforce, increased funding for GPE remains critical to addressing the pressing mental health needs of the nation. Benefits of GPE include increased access to mental health services, focus on cultural competence, and interprofessional collaboration.
• SAMHSA’s Minority Fellowship Program (MFP) facilitates the entry of people of color and individuals dedicated to minority mental health into careers in the mental health fields by providing funding for training, career development, and mentoring. MFP focuses on training students, postdoctoral fellows, and residents to be culturally and linguistically competent to adequately address the needs of underserved communities.

Psychological, Behavioral, and Mental Health Research Program

• The National Institutes of Health (NIH) is the world’s premier public funder of medical research. Within NIH, several institutes and offices are especially critical to science and research in the psychological and behavioral fields. This includes the National Institute of Mental Health (NIMH), which aims to treat mental illnesses through basic biomedical, behavioral, and clinical research, and the Office of Behavioral and Social Sciences Research (OBSSR), which coordinates and promotes basic, clinical, and translational research in the behavioral and social sciences. Increased funding will allow NIH to continue supporting this highly needed research.
• The National Science Foundation (NSF) supports research and education in non-medical fields of science and engineering. Increased funding will support critical psychological research within the Social, Behavioral, and Economic Sciences (SBE) Directorate, which accounts for more than 60 percent of the federal funding for basic social and behavioral science research, and the Computer Science Information Systems Engineering Directorate (CISE), which harnesses psychological science for much of its work, as human behavior plays a key role in designing and implementing new technologies, including artificial intelligence. NSF has also developed crucial funding mechanisms for climate and clean energy-related research, with an increasing focus on the role of behavioral and mental health research in efforts to mitigate and adapt to climate change.

School and Campus-Based Mental Health Programs

• The Department of Education’s Mental Health Service Professionals Demonstration Grant Program provides competitive grants to support the training of school-based mental health service providers through innovative partnerships between institutions of higher education and local educational agencies. The goal of this program is to increase the number and diversity of high-quality providers to address the shortages of mental health service professionals in high-need schools.
• The Department of Education’s School Based Mental Health Services Grant Program provides grants to state and local educational agencies to recruit and retain qualified mental health professionals, through a variety of strategies such as hiring and retention bonuses, relocation expenses, paid internships, scholarship programs, paying the salaries of new staff, and helping existing community mental health workers obtain the training and certification necessary to work in schools.
• SAMHSA’s Garrett Lee Smith (GLS) Campus Suicide Prevention Grant Program is the only federal program solely dedicated to addressing suicide prevention and mental health at institutions of higher education. GLS funding allows colleges and universities to expand services that support students at risk of suicide and suicide attempts, including those experiencing substance use disorders and mental health concerns.

Suicide Prevention Programs

• SAMHSA’s 988 Suicide and Crisis Lifeline provides nationalized services to effectively reach and serve all persons in a mental health or suicide crisis through a national network of 215 crisis call centers.
• SAMHSA’s Mobile Mental Health Crisis Response Grants support critical in-person responses to individuals in crisis when more assistance is needed than can be provided by a 988 crisis call counselor.
• The CDC’s Comprehensive Suicide Prevention Program funds 24 programs to implement and evaluate a comprehensive public health approach to suicide prevention, with a special focus on populations that are disproportionately affected by suicide.
• The Department of Veterans Affairs Suicide Prevention Programs include funding for suicide prevention and treatment programs, suicide outreach, including through the Veteran Crisis Line. APA Services requests $16.6 billion for VA Mental Health, including suicide prevention.

This holiday season, please give our elected officials the gift of your knowledge and expertise on why these programs are needed!  Advocacy matters! You can find their contact information at congress.gov.

Lastly, a National Academies committee will examine the current challenges in accessing behavioral health care services due to limited behavioral health practitioner participation in Medicare, Medicaid, and Marketplace insurance programs. The Committee is examining factors that incentivize or disincentivize behavioral health care provider participation in the Medicare, Medicaid, and Marketplace programs, with attention to provider type (e.g., physician, psychologist, advanced practice nurse, and social worker). The report will provide recommendations and innovative strategies to increase behavioral health workforce participation in these programs. You can provide input here.

As always, feel free to reach out with any questions/concerns.

Amy R. Beck, Ph.D., RYT 200

drbeckadvocates@gmail.com