The Centers for Medicare and Medicaid Services (CMS) issued a new rule on April 30 permitting audio-only telephone care for some psychiatry services. APA advocated strongly for this change so that patients without videoconferencing technology could continue to access care during the COVID-19 pandemic.
The impacted codes for psychiatry are 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, and 90853. The rule is retroactive to March 1 and will continue to be in effect through the end of the COVID-19 emergency declaration.
CMS also announced increased reimbursement for audio-only telephone visits between Medicare beneficiaries and their physicians to match payments for similar office and outpatient visits.
The new rule means that, when providing telemedicine care without a video component, psychiatrists should bill for evaluation and management (E/M) services using the codes for telephone visits (99441, 99442, 99443) regardless of whether they also provide psychotherapy.
APA sent a letter to Health and Human Services Administrator Seema Verma on April 2 urging CMS to relax restrictions on telehealth and allow psychiatrists to provide E/M services and psychotherapy via the telephone without requiring a video component.
“The individuals who have audio-only access tend to be the oldest and poorest of the population and need access to services,” said one member quoted in the letter. “The comparison is not with the ideal; the comparison is with no service at all, which is unacceptable.”
Many patients may not have a reliable broadband connection or the appropriate video technology to access care, Jay Shore, M.D., M.P.H., chair of APA’s Committee on Telepsychiatry and director of telemedicine at the Depression Center at the University of Colorado Anschutz Medical Campus, said in an email.
Other patients may not feel comfortable using video technology or may feel it is too much of a hassle, he added. “Allowing patients to use the telephone lowers the barriers to access,” he said.
“We applaud CMS for taking this step to further increase access to telehealth during the COVID-19 pandemic by allowing for audio-only visits,” said APA President Jeffrey Geller, M.D., M.P.H., in a news release about the rule. “This allows us to better treat our patients while respecting guidelines on physical distancing.”
“APA will continue to advocate for increased access to mental health care during this public health emergency,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., said in the news release. “We commend every action by CMS to increase access to telehealth so that our patients can access vital psychiatric services.” ■
More information on telehealth rules is posted
here.
APA’s letter to HHS is posted
here.
