To the Editor:

As I read the article “Understanding Medicare’s Mental Health Treatment Limitation” [Getting Paid, November/December, page 15], I became even more convinced that I’ll never get paid for mental health services without being devious and “gaming the system.”

The senior citizens in my practice won’t come in for psychotherapy visits. They will come in if the visit is for a medical concern – even though I may spend a lot of the visit on the patient’s mental health needs. If I then code the visit based on what actually transpired, Medicare will reduce payment. If I ask the patient for the difference, I’ll be told that Medicare will pay for treatment of the illness. To date, I’ve accepted financial losses in an effort to do the best for my patients, but it just keeps getting harder.