Updates to Behavioral Services Coming in 2020

The 2020 Open Enrollment Period began November 1 and ends December 15, 2019, so now is the time for your patients to get coverage. Since the insurance marketplace constantly changes, it’s good to review changes for the upcoming year. In 2020, there are new changes to Medicare and Medicaid services. The Centers for Medicare and Medicaid Services (CMS) state they take a strategic and cost-effective approach in informing individuals about Open Enrollment. Read about the new changes and how they will affect you and your patients. 

Behavioral Services Change for 2020

Some key updates for behavioral services include medicare deductibles for each period. In 2020, the inpatient amount raises from $1,364 to $1,408, about a $44 difference. From days 1-60, there is $0 coinsurance per day of each benefit period. Days 61-90 raises from $341 to $352 in 2020. Beyond 90 days, it goes from $682 to $704 coinsurance per each “lifetime reserve day” after day 90 for each benefit period, up to 60 days over a lifetime.

Beyond lifetime reserve days: all costs. 20 percent of the medicare-approved amount for behavioral health services your patients get from doctors and other providers while a hospital inpatient. For those in a psychiatric hospital, Part A only pays for up to 190 days on inpatient hospital services during your lifetime.

For behavioral providers, the American Psychological Association reports the CMS will accept an increase in psychologists receiving payments for health behavioral services in 2020; this change begins in January; codes are also changing; a proposed rule offers better medicare reimbursement. 

Affordable Care Act (ACA) Updates

2020 will see ACA enrollment dates shortening, from three months to now at six weeks, unless your patients qualify for a Special Enrollment Period. Premiums will also fall for an average of 4 percent in 2020. Your patients will also get more choices for insurers in many markets. The number of insurers offering plans on HealthCare.gov will rise from 155 to 175, with the second year of expansion. 

Exchange plan out-of-pockets will increase for 2020, however, so for a mid-tier individual silver plan will rise to 6 percent from $4,050 to $4,292’ family plan deductions are slated to rise at an average of 5 percent, from $14,873 to $15,551. These rates are for enrollees who don’t receive subsidies. CMS estimates subsidies will result in lower deductibles in 2020 for low-income enrollees. Also, more Americans may qualify for premium assistance since income limits are going up. Those who make up to $49,490 could qualify for tax credits, up from $45,490 this year. The income limit rises to $103,000 from $94,200 for a family of four.

Call Threshold Billing Solutions

To learn more about how we can help sort out all of your patient billing for 2020, please call us. We offer comprehensive services to aid your business and know about upcoming changes your patients need to know. You can count on our excellent staff to ensure all your behavioral billing is taken care of, so you can care for your patients.