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CSWA - Audio Only Psychotherapy for Medicare Confirmed! - 4-30-20

30 Apr 2020 10:40 PM | CSWA Administrator (Administrator)

I am pleased to confirm that LCSWs can now be reimbursed by Medicare for audio only psychotherapy sessions.  More details can be found at https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf

The CPT codes are the same as the ones that we use for in-person and videoconferencing sessions, e.g., 98034, 98037, 90791, etc. Any telephonic session that you have conducted since March 1 can be submitted for reimbursement.

The POS code should continue to be 11 as is has been for the past three weeks.  The modifier is 95.

This is the decision that CMS has made for Medicare coverage.  As we know, private insurers often follow the lead of Medicare policy, so there is a chance that we will see more coverage of audio only sessions by private insurers.  Do not take it for granted though, that this is the case. Continue to check the plan that each patient has if you wish to conduct treatment in an audio only format.

This also will not automatically apply to ERISA, or self-insured, plans.  We are continuing to pursue audio only coverage for those plans as well.

This is a big win for LCSWs and you all helped!  When we work together through CSWA, as well as with NASW and the American Psychological Association, we can accomplish great things.

Laura Groshong, LICSW, Director, Policy and Practice

PO Box 10
Garrisonville, Virginia  22463

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