Financing the medical management of mental disorders.

In 1987 Medicare benefits for the mentally ill were expanded for the first time in 22 years. A major change was the removal of limits and copayments for the "medical management of psychopharmacologic agents." Payment for medical management recognizes the trend toward the remedicalization of psychiatry; however, medical management can be defined either broadly or narrowly. The authors suggest pricing strategies for both medical management of mental disorders and psychotherapy. Enlightened design of psychiatric benefits will cover all forms of treatment according to appropriate rules. Access to treatment for mental illness is at stake as these rules develop.