CMS Proposes Permanently Covering Audio-Only Telehealth for Mental Health Services

The Centers for Medicare & Medicaid Services (CMS) recently released its proposed 2022 Physician Fee Schedule, which includes payment rates for Medicare next year, as well as several other policy proposals that might impact physicians.

Among them, CMS wants to make permanent Medicare coverage of audio-only mental health services via telehealth.

Many patients until now have been unable to access telehealth services of any kind because of where they live. A shortage of healthcare providers, coupled with limited or no access to broadband, are two key factors.

Medicare currently covers audio-only telehealth under temporary waivers issued during the Public Health Emergency (PHE). That emergency is expected to last through this year. The proposed rule would make it permanent, giving behavioral health patients continued access to care after the PHE is lifted.

The agency noted that while it continues to believe that two-way, audio/video communications technology is the appropriate general standard for telehealth services … “stakeholders have suggested that the availability of telehealth services for behavioral healthcare via audio-only communications technology would increase access to care.â€

CMS proposes to amend its regulation to define interactive telecommunications systems to include audio-only for established patients with mental health disorders when the originating site is the patient’s home.

To qualify, the practitioner must have seen the patient in person within six months of the first mental telehealth visit.

CMS is soliciting comments on whether additional documentation should be required in the patient’s medical record to support the clinical appropriateness of audio-only telemedicine, whether CMS should preclude audio-only telehealth for some high-level services such as psychotherapy with crisis, and the agency wants to know if additional guardrails should be considered to minimize concerns relating program integrity and patient safety.

CMS is soliciting comments until Sept. 13 at 5 p.m. Anyone may submit comments – anonymously or otherwise – via electronic submission at this link.

The Health Law Offices of Anthony C. Vitale can review your practice’s current telehealth policies and procedures for compliance or institute a new compliance program surrounding this new telehealth opportunity. For more information call us at 305-358-4500 or email info@vitalehealthlaw.com.