clinical social work association

Telemental Health Coverage after PHE Ends

Laura Groshong, LICSW, Director, Policy and Practice

March, 2023

The Public Health Emergency (PHE) is ending on May 11, 2023. This has caused some concern for LCSWs who have been working through telemental health since the pandemic began in 2020. The question of whether psychotherapy will be covered when the PHE ends is a complex one. Here is what we know about telemental health coverage at the moment:

• Coverage of Telemental Health – The Consolidated Appropriations Act of 2023 extended Medicare coverage of telemental health until December 31, 2024, which is good news. While most commercial insurers tend to follow CMS guidance, this time it appears that this may not be the case. Some insurers have already begun to limit telemental health coverage; this may increase after May 11. It is not too early to have patients check with their insurers about the likelihood that telemental health will be limited/no longer covered going forward.
• Meeting In-Person – The CMS requirement that Medicare patients be seen in person at least once a year when the PHE ends has been delayed until December 31, 2024.
• Audio-Only Telemental Health – CMS coverage of Medicare patients through audio-only telemental health will continue until December 31, 2024.
• If a patient’s insurer is planning to stop telemental health or audio only coverage in some way, it would be helpful to have patients talk to their HR person about keeping telemental health coverage in place. It may also be helpful to file a complaint with state insurance commissioners if insurers are unwilling to continue coverage of telemental health treatment.