CMS Issues Behavioral Health Telehealth Rule

The Centers for Medicare and Medicaid Services (CMS) issued a final rule that it says promotes wider use of telehealth in behavioral health. The CMS final rule on the Physician Fee Schedule for Medicare payments for calendar year 2022 eliminates restrictions on where patients can be when they seek mental health care via telehealth. Under the new final rule:

  • Medicare would allow for mental health telehealth visits to originate from within a patient’s home.
  • Geographic restrictions for mental health services offered via telehealth are eliminated.
  • Providers can do audio-only communications to diagnose and treat mental health disorders with established patients in their homes under certain circumstances—i.e., circumstances where a mental health provider could do a two-way video chat but the patient cannot use or refuses to consent to use the video chat system.
  • Providers are required to note that they were able to do an audio-only call but the patient wasn’t able to or didn’t want to use a video call.
  • The fact that mental health services include treatment for substance use disorder is clarified.
  • Medicare is permitted to pay rural health clinics (RHCs) and federally qualified health centers (FQHCs) for mental health services furnished via telehealth regardless of the public health emergency.
  • Similar rules about having patients come to an in-person appointment at least every 12 months apply to RHCs and FQHCs as well.