Reimbursement patterns for psychotherapy are in flux, noted Dr. Perry. In both the United States and Canada, health care payers "tend to undervalue psychotherapy relative to consultation and medication management." As a consequence, "more and more providers do not accept insurance or avoid certain types of insurance such as Medicare and Medicaid" for psychotherapy. Another reimbursement issue is payers’ deciding "who gets how much psychotherapy," Dr. Perry said. "I pray that a creative group of psychiatrists, health economists, and public health people, along with some government input, comes up with alternatives.
"Clearly, no one [reimbursement] system will work for every patient who needs psychotherapy."
Dr. West and Dr. Perry said they had no disclosures.