Why did Medicare pay 80 percent the first time I went to my psychiatrist but only 55 percent the next time?

Question: 
I am 72 years old and have Original Medicare. Over the last year I have been feeling more and more depressed. My daughter started to worry and suggested I see a psychiatrist. A few weeks ago I had my first few visits with a psychiatrist. I just received my Medicare Summary Notice (MSN) and I'm confused. For the first visit, Medicare paid the normal 80 percent, but after that, it looks like Medicare only paid 55 percent. Doesn’t Medicare pay 80 percent for all doctor visits?

Answer:
Medicare covers mental health services differently than it covers other types of doctor services. Medicare will pay 80 percent for your initial mental health visit so that your doctor can determine your diagnosis. However, Medicare will only pay 55 percent of its approved amount for future visits. The same payment rate applies to other mental health providers, such as psychologists and social workers.

There are a few other outpatient mental health services that are covered at 80 percent by Medicare. These are:

• brief office visits used to monitor or change your prescription
• partial hospitalization services not directly provided by a physician
• psychological testing to establish a diagnosis
• evaluation, management and other non-psychotherapy services provided by a mental health professional to manage Alzheimer's or senile dementia

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