Description
Medicare is the federal health insurance program for adults aged 65 and over, people with permanent disabilities (receiving government disability payments at least two years, including for mental illnesses), and people with end-stage renal disease or Amyotrophic Lateral Sclerosis (ALS). Federal law requires that all healthcare providers who work with Medicare beneficiaries either enroll in or opt out of Medicare. Too often mental health professionals are either unaware of this law or choose to ignore it. An overarching goal of this class is to provide accurate information about Medicare so clinicians may make an informed decision about enrolling in or opting out of Medicare. In 2024 the categories of mental health providers who are eligible to enroll in Medicare expanded to include licensed marriage and family therapists and licensed professional counselors (with a minimum of a master’s degree) in addition to postdoctoral level psychologists and licensed clinical social workers.
This introductory class covers detailed, current information about Medicare, including (1) an overview of the structure, (2) the legal regulations for all providers, (3) an understanding of the term “Medical necessity” and how it applies to mental health services, (4) rules specific to mental health services regarding telehealth, and (5) clinical interventions, documentation, billing, and reimbursement. This course includes financial information, both in terms of costs to Medicare beneficiaries and reimbursement to Medicare providers. Furthermore, the complex issues related to the Part C Medicare plans, known as Advantage plans, will be addressed. Additionally, ethical and legal considerations associated with providing Medicare services are discussed in the class. The material includes clinical case material to illustrate important aspects of the Medicare regulations.
Overall, there is a growing need for Medicare beneficiaries to have access to psychological services. However, often mental health providers are reluctant to enroll because they are unaware of the regulations and/or have been misinformed about them. Thus, an overarching goal of this course is to present timely and accurate information to demystify the opportunity to work within the Medicare system, as it can be meaningful clinical work and of great value to the public.
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CE Information
1.5 CE Credits
90 minutes
Cost
Free
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