clinical social work association

June 2, 2023

Here is some clarifying information about Medicare’s requirement that patients that are being seen through telemental health must have an in-person session every six or twelve months.

The language from Medicare is as follows (yellow outline is mine):

Telehealth includes certain medical or health services that you get from your doctor or other health care provider who's located elsewhere (or in the U.S.) using audio and video communications technology (or audio-only telehealth services in some cases), like your phone or a computer. You can get many of the same services that usually occur in-person as telehealth services, like psychotherapy and office visits.

Through December 31, 2024, you can get telehealth services at any location in the U.S., including your home. After this period, you must be at an office or medical facility located in a rural area (in the U.S.) for most telehealth services.

You can get certain Medicare telehealth services without being in a rural health care setting, including:

In short, diagnosis and treatment of mental health disorders will be covered by traditional Medicare until at least 12/31/24 without an in-person session. Audio only treatment will be covered “in some cases” so more guidance is needed on what the cases are that will be covered.

Treatment overseen by Medicare Advantage, or commercial insurers, may or may not require in-person sessions, and may or may not cover telemental health or audio only treatment.

I hope this clarifies the situation for now. Let me know if you need more information.

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