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Psychotherapy for Medicare Patients: Can Psychologists Do the Job?

The recent debate concerning the legitimacy of allowing psychologists to bill the government directly for psychotherapy provided to Medicare patients is critically evaluated. A review of outcome studies of psychotherapy in general and psychogeriatric studies in particular suggests that the government's insistence that further evidence be provided that psychotherapy “works” is misdirected. Given the large proportion of elderly individuals in poor mental health and data indicating that once brought into the mental health system they respond particularly well to psychotherapeutic intervention, psychologists should be granted the same eligibility status as physicians. A home-visit intervention program is outlined which would increase access to care, involve psychologists, psychiatrists, nurses, and other professionals and personnel-in-training, and monitor elderly patients' mental and physical health.