Mobi Health News — The Center for Medicaid and Medicare Services (CMS) has released an unpublished proposed rule that will soon lead to telehealth-favorable changes in reimbursement coverage under Medicare. It involves the proposal for Part B to expand the range of telehealth services that are reimbursed under medicare.
Adding New CPT Codes
Every year, CMS solicits requests to add services to the list of Medicare telehealth services. The deadline to submit requests is December 31 for the next rulemaking cycle. See this page for instructions.
This year, a number of changes were denied. Overall, CMS proposes to add seven new telehealth reimbursement codes, all in category 1.
What about Behavioral and Mental Health Reimbursement?
In mental healthcare, CMS has added codes for psychological testing, family therapy (two codes, one for family therapy with the patient present and one for family therapy with the patient absent), psychoanalysis and prolonged office visits. These latter codes will allow therapists to report sessions that go overtime or require additional time over the scheduled visit. Other codes will provide payment for annual wellness check ups, and chronic care management when conducted using remote monitoring equipment. The proposal also sets billing limits for services rendered via telehealth.
Kudos to the American Telemedicine Association for their advocacy efforts on behalf of telemental health. See this Politic365 article describing those efforts.
Previous TMHI blog discussions:
- Insurance Reimbursement: New List of All Telemental Health / Online Therapy Procedures Covered in 2013
- Medicare and Medicaid Proposed Rule to Cover Smoking Cessation
The time has come for nationwide health care licensing, much as we have nationwide driver’s licenses. If you’d like to be better informed regarding the issues surround licensure portability and other telehealth issues related to behavioral healthcare, you may be interested in reviewing this 1-hour webinar recording. It comes with
- a CE for most behavioral professionals
- video recording that covers the essential issues and
- several questions from the audience
To learn more about reimbursement, see TMHI’s 100% online course, entitled, “Reimbursement Strategies: Increasing Authorization and Payment.”