Psychologists Advancing Health Care for Older Adults

In 2002, the Centers for Medicare and Medicaid Services ("CMS") authorized a new series of procedure codes for psychologists to deliver professional services to Medicare beneficiaries.  These CPT codes are referred to as health and behavior codes ("H&B").  With these new tools, for the first time, psychologists can provide psychological assessment and treatment to patients based on a medical diagnosis, not a psychiatric diagnosis.  This was and continues to be a tremendous breakthrough, not only for professional psychology practitioners, but also for the tens of thousands of Medicare beneficiaries who are experiencing problems like anxiety and depression, or a sense of hopelessness or despair following the onset of an illness or disability.  This also means no stigma of a psychiatric diagnosis in order to receive help managing or coping with a disabling physical condition.

Of course, Medicare does not introduce new billable procedures for health care providers all the time.  The introduction of these codes sends a loud statement to both practitioners and to consumers that there is an interaction between a person's medical and psychological condition.  Addressing the medical symptoms without consideration of the psychological symptoms - the emotions, the behaviors, and the attitudes - is not addressing the whole person.  Both dimensions must be considered, and the "H&B" codes authorized under Medicare foster the integration of health care services for older adults.

This latest trend, as old as it is obvious, is to treat the whole person.  With psychologists now collaborating with the primary care team, and sharing perspectives and treatment plans that take into account a patient's understanding of his medical condition, what he can do to better cope, manage, or recover from his illness, his feelings about complying with the plan, and his future outlook, care becomes more patient-centered, more comprehensive, and more cost-effective.  It also means that, to the extent that the patient is more involved in his own care, he also takes more responsibility for behavior change.

If interested in learning more about this topic see my online course on Advancing Behavior Medicine in LTC Settings using the Health and Behavior Codes at CoHealth.org.