During the first year of the COVID-19 public health emergency, Medicare improperly paid for $580 million of psychotherapy care, including $348 million of telehealth services, according to an audit by the Department of Health and Human Services’ Office of the Inspector General.
The report, which estimated that Medicare paid for $1 billion of psychotherapy that year, included more than 13.5 million psychotherapy services provided from March 2020 through February 2021, Mobi Health News reports.
The agency chose two stratified random samples of psychotherapy services during the period, one group of 111 enrollee days for telehealth and another sample of 105 enrollee days for in-person care. According to the OIG, an enrollee day includes all claim lines for Medicare Part B psychotherapy with the same service start date for a particular enrollee.
For 128 of the 216 total sampled enrollee days, providers didn’t meet Medicare requirements. For example, in 60 sampled enrollee days, psychotherapy time wasn’t documented. In 43 enrollee days, treatment plans were incomplete or missing. Read more.
