CMS has good news for you and your patients regarding the telehealth mental health care you’ve provided since the pandemic: Medicare will continue to reimburse for these services for at least two more years.
Originally, the addition of reimbursement for telehealth mental health services was temporary due to COVID, and expected to expire at the end of 2021. However, the 2022 CMS Physician Fee Schedule changes have extended this through Dec. 31, 2023. CMS stated that this extension provides them with additional time to fully evaluate whether telehealth mental health services should be permanently added to Medicare’s covered treatments list.
To be eligible for this reimbursement, you must also comply with several additional modifications related to how and when you can provide telehealth mental health services:
- Geographic Restrictions: Section 123 of the Consolidated Appropriations Act, 2021 (CAA) removed the geographic restrictions for telehealth mental health care, adding a Medicare patient’s home as an allowable originating site for care. This means you can see patients virtually even if they don’t come into your office for their initial visits.
- In-person Visit Schedule: Patients must come into your practice for an in-person, non-virtual visit at least once every 12 months (they can be more often if you choose). Exceptions to this rule will be made for patients who have an allowed reason documented on their Medicare ID card, such as a disability that leaves them homebound.
- Technology: The definition of “interactive telecommunications system for telehealth services” was also amended under CMS’s Physician Fee Schedule Final Rule. Previously, Medicare would only authorize reimbursement if both your practice and patient used a platform that offered video AND audio communication. With these added changes, audio-only visits are accepted if:
- Your patient isn’t capable of video communication, either because their device doesn’t support video or they can’t figure out the technology
- Your patient doesn’t consent to using video
To get a breakdown the most significant 2022 CMS Physician Fee Schedule changes to your practice (beyond just telehealth medical health), check out Healthcare Training Leader’s immediately available online training. During this 90-minute session, expert coder and educator, Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, will provide you through the most impactful fee schedule changes, and walk you through how to accurately incorporate them. Access this training today!
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