On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) announced its Calendar Year (CY) 2022 Physician Fee Schedule (PFS) final rule to promote greater use of telehealth and other telecommunications technologies for providing behavioral health care services.
Specifically, CMS’ final rule includes the following changes to the provision of behavioral health care services by telehealth:
• The final rule eliminates geographic barriers to telehealth and allows patients to access telehealth services for diagnosis, evaluation, and treatment of mental health disorders in their homes.
• The final rule permits certain mental and behavioral health services to be provided via audio-only telephone calls, including counseling and therapy services, and treatment of substance use disorders and services provided through opioid treatment programs. However, to provide services by audio-only telephone calls, the distant site physicians and clinical professionals are required to have the technical capacity to use an interactive telecommunications system that includes two-way, real-time, interactive audio and video communications at the time that the telehealth service provided by audio-only is furnished.
• The final rule allows Medicare to pay for mental health visits provided by rural health clinics and federally qualified health centers via telecommunications technology, including audio-only telephone calls.
In addition to the changes regarding telehealth for behavioral health care services, CMS’ CY 2022 PFS also:
• Expands the Medicare Diabetes Prevention Program
• Provides increased access to medical nutrition therapy services
• Provides additional reimbursements for vaccines
• Expands pulmonary rehabilitation coverage for individuals who have had confirmed or suspected COVID-19
• Makes several changes to the Quality Payment Program
• Introduces the first seven Merit-Based Incentive Payment Systems (MIPS) Value Pathways
• Updates the clinical labor rates used to calculate practice expense under the PFS
• Allows physician assistants to bill Medicare directly for professional services furnished under Medicare Part B
CMS’ unpublished final rule was made available on November 2, 2021, and will be officially published in the Federal Register on November 19, 2021. The extensive final rule can be viewed in its entirety here.
If you have any questions regarding the content of this alert, please contact Dena DeFazio, associate, at ddefazio@barclaydamon.com, or another member of the firm’s Health & Human Services Providers Team.