Medicare Coverage of Telemental Health
The COVID-19 pandemic took a toll on the nation’s mental health. During this time, Medicare, and other agencies, focused more attention on telehealth. As a result, beneficiaries were able to access some health care amid stay-at-home orders, with specialists like behavioral health providers seeing the highest telehealth utilization relative to other providers.
This year, Medicare is increasing the availability of mental health services via telehealth. Let’s take a closer look at the Medicare telehealth coverage improvements for mental health.
Medicare has permanently removed geographic restrictions for mental health and substance use services and permanently allows beneficiaries to receive those services at home. In addition, Centers for Medicare & Medicaid Services (CMS) has made several changes under its regulatory authorities to make certain telemental health changes permanent.
First, to help protect access to care and permanently eliminate geographic barriers, CMS announced that for the first time outside of the COVID-19 public health emergency (PHE), Medicare will pay for mental health audio-only telemental health services used to diagnose, evaluate, and treat mental health disorders.
Other permanent modifications by CMS include the addition of many new telemental health services (e.g., group psychotherapy, low-intensity home visits). The agency also added types of providers — including clinical psychologists, physical therapists, occupational therapists, and speech-language pathologists — authorized to furnish certain remote care, like online assessment and management services, virtual check-ins, and remote evaluations.
Other Medicare services added to the telehealth services list temporarily during the PHE will remain in place through December 31, 2023, while CMS continues to evaluate whether these services should be permanently added to the Medicare telehealth services list.
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