{"id":40686,"date":"2022-11-01T12:32:00","date_gmt":"2022-11-01T16:32:00","guid":{"rendered":"https:\/\/mtelehealth.com\/?p=40686"},"modified":"2022-11-01T12:32:00","modified_gmt":"2022-11-01T16:32:00","slug":"cms-loosens-telehealth-rules-provider-supervision-requirements-for-behavioral-health","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-loosens-telehealth-rules-provider-supervision-requirements-for-behavioral-health\/","title":{"rendered":"CMS Loosens Telehealth Rules, Provider Supervision Requirements for Behavioral Health"},"content":{"rendered":"\n\n\n

The Centers for Medicare & Medicaid Services (CMS) finalized new rules aimed at expanding access to behavioral health for Medicare beneficiaries.<\/p>\n\n\n\n

On Tuesday, CMS announced it finalized rules that allow for greater flexibility in billing and supervising certain types of providers as well as permanently covering some telehealth services provided in Medicare beneficiaries\u2019 homes.<\/p>\n\n\n\n

They appear to largely be in line with the proposed rules released by the federal health care regulator. CMS released the proposed rules for\u00a0the 2023 Physician Fee Schedule<\/a>\u00a0and the 2023\u00a0Hospital Outpatient Prospective Payment System<\/a>\u00a0in July.<\/p>\n\n\n\n

All in all, these rules are meant to realize the Biden administration\u2019s unity agenda and the U.S. Health and Human Services Department\u2019s Roadmap to Behavioral Health Integration.<\/p>\n\n\n\n

\u201cAccess to services promoting behavioral health, wellness, and whole-person care is key to helping people achieve the best health possible,\u201d CMS Administrator Chiquita Brooks-LaSure said in a news release. \u201cThe Physician Fee Schedule final rule ensures that the people we serve will experience coordinated care and that they have access to prevention and treatment services for substance use, mental health services, crisis intervention, and pain care.\u201d<\/p>\n\n\n\n

Medicare Physician Fee Schedule final rule<\/h3>\n\n\n\n

The final rule for the physician fee schedule will authorize providers to bill for services provided by licensed professional counselors (LPCs) and licensed marriage and family therapists (LMFTs). CMS created an exception to allow for these providers to bill under general supervision of a physician or non-physician practitioner, rather than direct supervision.<\/p>\n\n\n\n

The final physician fee schedule rule also clarifies that any mental health or substance use disorder (SUD) treatment service is provided by and billed under general supervision.<\/p>\n\n\n\n

In practical terms, this new rule would no longer require supervising clinicians to be on-site for certain behavioral health services to be billable to Medicare. Thus, it would be easier for Medicare beneficiaries to see these providers.<\/p>\n\n\n\n

In 2024, CMS will address payments for new codes that describe \u201ccaregiver behavioral management training,\u201d according to a fact sheet<\/a>.<\/p>\n\n\n\n

On the SUD front, Medicare will pay opioid treatment programs (OTPs) to start medication-assisted treatment (MAT) with buprenorphine via telehealth. OTPs may also bill for opioid treatment provided through mobile units.<\/p>\n\n\n\n

CMS also created new codes for general behavioral health integration that tracks services provided by clinical psychologists and licensed clinical social workers in primary care settings. A psychiatric diagnostic evaluation may serve as the initiating visit for the new general BHI service, according to a news release.<\/p>\n\n\n\n

Hospital Outpatient Prospective Payment System final rule<\/h3>\n\n\n\n

The final rule for the outpatient prospective payment system makes permanent a public health emergency era flexibility that allows hospital outpatient departments to bill for in-home telebehavioral health services.<\/p>\n\n\n\n

It also requires that patients have an in-person visit within 6 months before the telehealth visit and again every 12 months thereafter. The rule allows for exceptions to the in-person requirement if patients and providers \u201cagree that the risks and burdens of an in-person service outweigh the benefits of it,\u201d a fact sheet<\/a> states.<\/p>\n\n\n\n

It also permits audio-only visits when a beneficiary isn\u2019t able to use two-way audio and video technology.<\/p>\n\n\n\n

Not included in the proposed rule, the outpatient prospective payment system final rule that new Healthcare Common Procedure Coding System (HCPCS) codes for telehealth will be recognized as partial hospitalization program (PHP) services.<\/p>\n\n\n\n

A hospital may bill for non-PHP outpatient services furnished to a PHP patient such as therapy. But hospitals may not bill them as PHP services but will be required to comply with documentation requirements that apply to PHP patients.<\/p>\n","protected":false},"excerpt":{"rendered":"

The Centers for Medicare & Medicaid Services (CMS) finalized new rules aimed at expanding access […]<\/p>\n","protected":false},"author":3,"featured_media":40671,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[62,14,186,239,159],"tags":[],"class_list":["post-40686","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-behavioral-health","category-blog","category-medicare","category-physician-fee-schedule","category-telehealth"],"acf":[],"yoast_head":"\nCMS Loosens Telehealth Rules, Provider Supervision Requirements for Behavioral Health · Dr. Miltie, LLC - At-Home Testing<\/title>\n<meta name=\"description\" content=\"The Centers for Medicare & Medicaid Services (CMS) finalized new rules aimed at expanding access to behavioral health for Medicare beneficiaries. 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