clinical social work association

April 29, 2021

Many members have been asking questions about the Medicare coverage of telemental health. This is an important topic because most commercial insurers follow Medicare policies regarding coverage of telemental health, as well as other coverage issues.

Medicare has covered telemental health videoconferencing for our usual and customary psychotherapy codes since March, 2020, a major expansion of telehealth coverage. Medicare also agreed to cover audio only psychotherapy in April of 2020. Both were tied to the Public Health Emergency (PHE) being in effect. The PHE was extended in three month increments until April of 2021 when CMS announced that telemental health videoconferencing would be extended until the end of 2021. Audio only treatment would be covered as long as the PHE was in effect. See https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes for more information.

In other words, separation of telemental health videoconferencing and audio only coverage have been part of the expansion of psychotherapy coverage since the pandemic began. The current intention from the current administration is that the PHE continue through 2021, which would make the difference between the two delivery systems moot.

At this point, I believe that LCSWs can reasonably expect coverage of telemental health and audio only treatment to last through 2021. There are several bills in Congress which would make this policy permanent. Our Government Relations Committee is working hard to see one of these bills pass. Stay tuned.

- Laura W. Groshong, LICSW, CSWA Director of Policy and Practice