Clinical Social Work: Reimbursement

On December 1, 2020, the Centers for Medicare & Medicaid Services released the final rule for the Medicare Physician Fee Schedule. The rule is effective January 1, 2021, and applies to Medicare providers, including clinical social workers (CSWs). This NASW Practice Alert summarizes the rule provisions that apply to CSWs.

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.

In 2020, there are several important national updates that clinical social workers (CSWs) should be aware of to help them maintain an effective business and clinical practice. These updates include the areas of coding, claims, quality payment, and reimbursement.

In 2013, 90837 was one of several psychotherapy procedural codes introduced to health care professionals such as clinical social workers and the health insurance industry.

NASW receives questions from clinical social workers about how to terminate their contracts as insurance providers and move to a private pay fee-for-service practice. This practice perspective highlights several important steps to facilitate the transition.

Clinical social workers (CSWs) in private practice make decisions as they manage their practice about accepting insurance,cash payments, and contracting with alternative payers.