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New CMS Interim Final Rule/Telehealth

  • 1.  New CMS Interim Final Rule/Telehealth

    Posted 04-30-2020 17:32
    Hi Association Executives,

    Please keep in mind we are still reviewing what these changes mean for you and our members. 

    Today, the White House announced new changes to CMS regulations, including increased reimbursement and flexibility to bill for additional Medicare audio-only telehealth services, in certain circumstances.

    Our preliminary review of the regulation indicates the following changes for the duration of the public health emergency:

     

    • Increase in reimbursement for audio-only E/M codes: Previous guidance permitted billing for audio-only telehealth visits for certain CPT codes, including virtual check-ins and some evaluation and management codes. CMS is now increasing payments for specified E/M telephone encounters to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.
    • Expansion of audio-only billing for Opioid Treatment Programs (OTPs): Previous guidance permitted therapy and counseling to take place via audio-only telehealth in OTPs. OTPs will now be able to do periodic assessments via audio-only calls.
    • Expansion of telehealth for partial hospitalization programs: In the context of hospital and outpatient partial hospitalization programs, individual psychotherapy, patient education, and group psychotherapy can now be billed as telehealth visits, including via audio-only encounters when audio/video technology is not available. All other PHP requirements remain unchanged, including that all services furnished under the PHP still require an order by a physician, must be supervised by a physician, and others. These encounters may take place with the patient in their own home.

     

    The National Council continues to analyze the rule and its implications for our members, and will provide more information.  In the meantime, the Interim Final Rule can be found here: https://www.cms.gov/files/document/covid-medicare-and-medicaid-ifc2.pdf.

     

    For additional information, please visit our COVID-19 resource site: https://www.thenationalcouncil.org/covid19/


    Questions? Please send them to policy@thenationalcouncil.org


    Thank you,
    Frankie



    ------------------------------
    Frankie Berger
    Director, State Policy and Advocacy
    National Council for Behavioral Health
    202-684-3727
    ------------------------------


  • 2.  RE: New CMS Interim Final Rule/Telehealth

    Posted 05-05-2020 18:14

    Dear Association Executives,

     

    As discussed on today's call, I'm sending along an update on the CMS IFR regarding an expansion of audio-only billing codes in Medicare:

     

    Moving forward, CMS will be making any updates to Medicare telehealth codes via subregulatory guidance, specifically, this spreadsheet of codes that are billable as telehealth encounters in Medicare.

     

    The National Council has been actively urging CMS to expand the codes that can be conducted as audio-only visits, and we were pleased to see that as of last week, many of the behavioral health codes in the list can now be done as audio-only encounters, including codes for individual and group therapy, diagnostic evaluation, and much more.

     

    Additional changes to telehealth for behavioral health services are outlined in Frankie's email below.

     

    Please don't hesitate to let us know if you have any questions.

     

     

     

    Rebecca Farley David
    Senior Advisor, Public Policy & Special Initiatives
    National Council for Behavioral Health
    1400 K Street NW Suite 400, Washington, DC 20005
    Direct: (202) 684-3735
    Email: RebeccaD@TheNationalCouncil.org
           
    www.TheNationalCouncil.org  
    Conf20!

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    Hi Association Executives,  Please keep in mind we are still reviewing what these changes mean for you and our members.  Today, the White...

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    New CMS Interim Final Rule/Telehealth

    Frankie Berger

    Apr 30, 2020 5:32 PM

    Frankie Berger

    Hi Association Executives, 

    Please keep in mind we are still reviewing what these changes mean for you and our members. 

    Today, the White House announced new changes to CMS regulations, including increased reimbursement and flexibility to bill for additional Medicare audio-only telehealth services, in certain circumstances.

    Our preliminary review of the regulation indicates the following changes for the duration of the public health emergency:

     

    • Increase in reimbursement for audio-only E/M codes: Previous guidance permitted billing for audio-only telehealth visits for certain CPT codes, including virtual check-ins and some evaluation and management codes. CMS is now increasing payments for specified E/M telephone encounters to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.
    • Expansion of audio-only billing for Opioid Treatment Programs (OTPs): Previous guidance permitted therapy and counseling to take place via audio-only telehealth in OTPs. OTPs will now be able to do periodic assessments via audio-only calls.
    • Expansion of telehealth for partial hospitalization programs: In the context of hospital and outpatient partial hospitalization programs, individual psychotherapy, patient education, and group psychotherapy can now be billed as telehealth visits, including via audio-only encounters when audio/video technology is not available. All other PHP requirements remain unchanged, including that all services furnished under the PHP still require an order by a physician, must be supervised by a physician, and others. These encounters may take place with the patient in their own home.

     

    The National Council continues to analyze the rule and its implications for our members, and will provide more information.  In the meantime, the Interim Final Rule can be found here: www.cms.gov/files/document/....

     

    For additional information, please visit our COVID-19 resource site: www.thenationalcouncil.org/covid19


    Questions? Please send them to policy@thenationalcouncil.org


    Thank you,
    Frankie



    ------------------------------
    Frankie Berger
    Director, State Policy and Advocacy
    National Council for Behavioral Health
    202-684-3727
    ------------------------------

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