Medicare TelehealthThe Covid-19 pandemic was accompanied by a dramatic increase in demand for mental health services from standard mental health treatment to substance abuse disorder treatment. Contrary to common sense, Medicare recipients were required to see a provider in person within six months of getting telehealth services. See New Medicare Law Requires In-Person Visit for Telehealth Coverage. Enter a bipartisan group of four senators who introduced legislation entitled the “Telemental Health Care Access Act of 2021” on June 15th. The bill amends Section 123 of the Consolidated Appropriations Act to remove the in-person mandate.

Telemental Health Care Access a Timely Issue

Senator Tina Smith, one of four senators sponsoring the legislation, noted that telehealth was key to accessing treatment for Medicare patients during the public emergency: “During the pandemic, telehealth helped eased Americans’ fears by allowing them to avoid the risk of visiting a hospital or clinic. Now we have the opportunity to build on this success, bypassing our bipartisan bill to make sure Medicare patients are able to access telemental health services without additional barriers.”

Other organizations that support telehealthcare in general also praised the legislation: “The Telemental Health Care Access Act is a critical piece of legislation that would repeal the telemental health in-person requirement. Passing this legislation and ensuring this unnecessary requirement is not repeated for other services, along with other pieces of legislation that make the telehealth waivers permanent, could not be a higher priority for the ATA and our members,” said Ann Mond Johnson, CEO of the American Telemedicine Association.

The week before the legislation was introduced, supporters of the legislation CTeL hosted a “Hill Day” to try and convince legislators to move on the matter. After the introduction of the legislation, CTeL lauded the Act as a step forward: “We are thrilled that Congress headed [sic] our advice and are considering this important policy change. Congress must address this burdensome requirement, which undercuts the very important tenants around flexibility and access afforded by telehealth.”

A Step Forward for Breaking Down Barriers to Telemental Health Treatment

The Telemental Health Care Access Act of 2021 is another step in breaking down barriers to telehealth treatment that started with legislation called the SUPPORT for Patients and Communities Act in 2018; that act removed various requirements for substance use disorder telehealth treatment. More recently, a piece of legislation was passed as part of an end-of-year package in 2020 that expanded access for Medicare patients to receive services via telehealth in their homes or at other sites. See more previous TBHI news related to Medicare Telehealth and Medicare Telemedicine reimbursement.

Suicide Prevention a Key Impetus for the Act

Suicide and the depression that can lead to it were the major concerns behind the Telemental Health Care Access Act of 2021. Laurel Stine, Senior Vice President of Public Policy of the American Foundation for Suicide Prevention, said, “One of the leading causes of suicide among older adults is depression, and early identification and effective treatment is paramount in saving lives.”

“Telehealth has been essential for maintaining and expanding access to healthcare services during the COVID19 pandemic.,” said Senator Ben Cardin, another of the four senators sponsoring the Act, “This is especially true for those seeking mental health counseling and medical management, as we have seen spikes in anxiety, depression, substance abuse, domestic violence and suicide resulting from social isolation.” See New Act to Allow Counselors Medicare Telehealth Reimbursement.

More information is available in the press release from Senator Bill Cassidy here.

Why Are Changes in Medicare Telehealth Important for Telehealth Professionals?

As TBHI has recently reported, professionals and organizations seeking to grow their telehealth services in the future would do well to consider specializing in medicare telehealth if they wish to have their services reimbursed. In fact, the future is particularly promising for those professionals who develop specializations in co-morbid chronic illness and behavioral health. These include cancer, cardiology, diabetes, chronic obstructive pulmonary disease, and psychiatry. By developing one’s skills for working with clients and patients with these particular medical challenges who are medicare beneficiaries, behavioral professionals will truly be in a prime position for telehealth expansion in the coming years. For details, see Future of Telehealth Reimbursement: Offering Medicare Telehealth Services?

 

How to Pay for Telehealth in 2021 course

How Can I Get Paid for Telehealth in 2021?

Hold on to your hat! TBHI pulls out all the stops and with this fast-paced webinar designed to provide a 2021 telehealth reimbursement update to bring you up to speed with telehealth and telemedicine CPT codes, telehealth modifier codes, and often-neglected additional fees that can be collected for telehealth. Information obtained from online searches or from colleagues can be incorrect and lead to claim denials. This training is relevant to all behavioral professionals nationwide, whether accepting reimbursement from private payers, Medicare or Medicaid as well as professionals who don’t directly work with insurance.

PLEASE NOTE: the Telebehavioral Health Institute (TBHI) has recently been rebranded and is now known as Telehealth.org

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