Supporting Sustainable Mental Health Care in Kentucky

Our Commitment Remains Unchanged

At Twilight Psychology, our commitment to providing high-quality, compassionate mental health services to the Kentucky community remains our highest priority. We’re writing to share important information about how we’re adjusting our operations to ensure we remain a stable, accessible resource for years to come.

Good news for our current patients: We are actively hiring three new clinicians in July and August, and waitlist times for existing clients will not increase. In fact, you can expect them to reduce as our new team members onboard and build their caseloads. There are no immediate changes to service availability.

The Challenge: A Perfect Storm

In June 2026, the Kentucky Department for Medicaid Services announced a 4% reduction in provider reimbursement rates, effective August 1, 2026. Like many healthcare providers across the Commonwealth, this presents a significant challenge to our sustainability.

But this cut is only part of a larger financial squeeze. Psychological testing services—our core specialty—have been hit especially hard:

• Stagnant reimbursement: The CPT codes for psychological testing (90791, 96136, 96137, 96130, 96131) have not seen a rate increase since 2018
• Unequal treatment: Therapy services received Medicaid rate increases on April 1, 2026, but psychological testing was excluded
• Rising costs: Testing supplies from providers like Pearson and WPS have increased significantly in cost
• Resource intensity: Comprehensive evaluations require substantial clinician time, specialized expertise, and careful documentation

We are one of the few practices in Kentucky that conducts rigorous comprehensive evaluations and accepts insurance for this service. For years, we absorbed these growing costs to serve Medicaid patients. However, we cannot continue this approach without jeopardizing the quality of evaluations or the long-term health of our practice.

Why We’re Acting Now (And What That Means)

Rather than waiting for financial pressure to force our hand, we’re being proactive. The combination of the Medicaid rate cut and years of stagnant reimbursement for testing services has motivated us to transition to a more sustainable service model—but this transition is not imminent, and existing clients have nothing to worry about.

Here’s our timeline:

• July–August 2026: Three new clinicians join the team. As they build their caseloads, waitlist times will actually decrease.
• Fall/Winter 2026: We will carefully implement a more balanced service model to ensure long-term fiscal health and continued quality care.
• Existing clients: Your care continues without disruption. No sudden changes to your waitlist position or access.

Our Solution: A Balanced Approach

To remain a stable, sustainable resource for the Kentucky community, we are thoughtfully adjusting our service capacity over the coming months. This shift is designed to protect both the quality of our work and our ability to continue serving Medicaid patients long-term.

What’s Changing (Later in the Year)

Starting in the fall, we will prioritize the depth and quality of every evaluation we conduct. This means adjusting how many comprehensive psychological tests we perform at any given time, allowing us to dedicate proper resources to each patient’s diagnostic process—and ensuring we remain financially healthy as a practice.

What This Means for You

• Short-term: Waitlist times will improve as we add clinicians this summer
• Long-term: By adopting a more sustainable service model, we protect our ability to continue serving Kentucky Medicaid members and accepting insurance for years to come
• Your care: If you are currently a patient, these changes will not negatively impact your access or experience
• Transparent pricing: If you prefer faster access when capacity is constrained, self-pay options are available

You can view our current waitlist times to help plan your care accordingly.

Our Core Commitment

We are not closing our doors or abandoning Medicaid patients. We are making a proactive, strategic choice to ensure that Twilight Psychology remains fiscally healthy, staffed, and able to provide the highest standard of care for years to come.

We’re Here to Help

We understand that service adjustments can create uncertainty. This decision reflects our deep commitment to transparency and ensuring the long-term wellbeing of our patients and the Kentucky community.

If you have questions about how this affects your care, coverage, or next steps, please reach out. We’re here to help you navigate this transition.

Resources & Next Steps

• Current Waitlist Times — Check current wait times for psychological testing services
• Fees & Insurance — Review self-pay rates and what to expect with insurance coverage
• Accepted Insurances — See which plans we accept for each service type
• Psychological Evaluations — Learn more about our comprehensive evaluation process
• Contact Twilight Psychology — Reach out if you have questions about service availability or your care

Thank you for your continued trust in Twilight Psychology.