Reimbursement Repercussions for April 2023 End of Public Health Emergency – Telehealth.org

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While the official end of the public health emergency (PHE) was extended to April 2023 for many federal government programs, two federal actions will further extend the deadline for federal Medicare reimbursement until at least December 31, 2024. A notable requirement for mental health telehealth providers to see their clients and patients in person was…

While the official end of the public health emergency (PHE) was extended to April 2023 for many federal government programs, two federal actions will further extend the deadline for federal Medicare reimbursement until at least December 31, 2024. A notable requirement for mental health telehealth providers to see their clients and patients in person was announced, despite telebehavioral health being permanently approved for medicare reimbursement in 2022. Other repercussions of the end of the PHE include the return of HIPAA and licensure enforcement.

Meanwhile, active legislation to mitigate the negative repercussions of the end of the PHE includes the following:

Permanent Telehealth Reimbursement Changes

  • Medicare reimbursement for eligible telehealth services including telebehavioral health when the patient is located in a geographically rural area AND in an eligible originating site
  • Medicare reimbursement for mental health telehealth services (including audio-only services in some cases)
  • For behavioral health, an in-person visit is required within the first six months of an initial telehealth visit and every 12 months thereafter, with certain exceptions, starting January 1, 2025.

Changes In Effect Until 12/31/2024

Medicare beneficiaries can receive telehealth care from any location, including their homes, with exceptions.

  • In addition to medical and mental health telehealth providers including psychologists, social workers, counselors and marriage and family therapists, Medicare reimbursement will be available for occupational therapists, physical therapists, speech-language pathologists, and audiologists.
  • Reimbursement of FQHCs and RHCs will continue as distant site telehealth providers for services unrelated to mental health.

Eliminated

Prescribing controlled substances via telemedicine will be forbidden without an in-person examination, except in specific circumstances, if further actions are not taken by the Drug Enforcement Agency (DEA). As a result of many groups lobbying for modification of the Ryan Haight Act, a proposed rule by the Substance Abuse and Mental Health Services Administration is in process. It would permanently allow telemedicine…

From Telebehavioral Health Institute – Read More

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