clinical social work association

The National Voice of Clinical Social Work 

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Medicare Coverage Follow-up - 2023

December 17, 2022 2:53 PM | Anonymous

CSWA would like to clarify information about the rules that CMS and Congress will be putting into place when clinicians provide telemental health treatment under Medicare when the Public Health Emergency ends.

No one knows when the Public Health Emergency (PHE) will end.  When it does, the following rules go into effect 151 days after the PHE ends.

  1. Until 151 days after the PHE ends, you do not need to see anyone in person in order to provide telemental health treatment. After that time, CMS Guidelines require that you see a new patient one time in person before beginning to see that patient virtually. After that, you will need to see the patient in person once a year.
  2. For patients you already see through telemental health treatment, you need to have seen them at least once in person within the past 6 months in order to continue seeing them virtually. If you have not seen them in person within the past 6 months, you will need to do so the first time you see them when the rules go into effect. After that initial in person session, you will need to see them again in person at least once per year.

While there is no requirement that the rules will apply to commercial insurers, they often follow the Medicare rules. At this time, there are no insurers who have said they will require the above rules.

Some of us no longer have a physical office anymore, are concerned about getting COVID, or want to avoid in-person meetings for other reasons. CSWA is working with the Mental Health Liaison Group (MHLG) and Congress to eliminate the requirement to see patients in person.

In short, there is no need to see patients in person currently. CSWA will let members know when or if this requirement goes into effect.

Happy holidays,

Laura Groshong, LICSW, Director, Policy and Practice

PO Box 105
Granville, Ohio  43023

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