![]() The patient must have received an in-person service within six months of the initial telehealth service, and the telehealth visit must be billed with a modifier. Federally Qualified Health Centers and Rural Health ClinicsĬMS will allow patients in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to receive mental health and SUD services through audio-communications technology. ![]() This reflects the loss of 3.75% in additional funding from Congress for this year that ends on December 31, 2021. Under the final rule the 2022 CF will be $33.59 or 3.75% lower than the current CF of $34.89. Multiple family group psychotherapyĪPA asked CMS to add multiple family group psychotherapy (90849) to Medicare’s permanent telehealth list but the agency declined, noting that generally the code is not separately payable in Medicare as an in-person service.ĪPA urged CMS to work with Congress to avoid a 3.89% cut to the 2022 conversion factor (CF), the figure that is multiplied by each service’s relative value units to determine its reimbursement amount. CMS adopted this proposal, keeping psychological and neuropsychological testing on the temporary (category 3) telehealth list through the end of 2023.ĪPA asked CMS to also add the codes for developmental testing and adaptive behavior services to the telehealth list through the end of 2023, but the agency did not adopt this idea. Psychological and neuropsychological testing remain temporary telehealth services through December 2023.ĪPA supported CMS’s proposal allowing all psychological and neuropsychological testing services to be provided via telehealth after the PHE ends. CMS will not require additional documentation but providers furnishing audio-only services will need to use a billing modifier on claims to indicate that the patient did not have access to two-way audio-visual communication technology or did not consent to its use. Providers will be able to request exemptions if they believe it would benefit the patient not to meet in-person. Under the final rule, once the PHE ends, audio-only telehealth services for mental health and substance use disorder (SUD) services will require an in-person visit within six months of the initial telehealth visit and within 12 months of any subsequent telehealth visit. Absent new federal legislation, health behavioral services, feedback sessions for psychological and neuropsychological testing evaluations, and other services will not be allowed via audio-only technology after the PHE ends.Īdditional requirements for audio-only servicesĪPA advocated against imposing additional requirements-such as periodic in-person visits or additional documentation other than a modifier-for coverage or reimbursement of mental or behavioral health services furnished via telehealth. However, Health Behavior Assessment and Intervention services will be excluded from audio-only coverage once the PHE ends. The agency agreed with APA’s request to continue coverage and reimbursement of high-level psychotherapy services furnished via audio-only devices beyond the end of the PHE. ![]() The originating site requirement will not apply when patients receive these services through audio-only devices in their homes, with the definition of home being viewed broadly to include temporary lodging, such as a hotel. Reimbursement for audio-only services for mental health will continue after the public health emergency endsįollowing changes made through new federal legislation, CMS will allow audio-only services to be provided for the diagnosis, evaluation, and treatment of mental health conditions and substance use disorders after the public health emergency (PHE) ends.
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