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The Mental Health Telemedicine Expansion Act – H. R. 1301 was passed into law as part of the Omnibus Appropriations and Coronavirus Relief Package on December 21, 2020. An abbreviated version excerpted for the telehealth community can be found here: Unprecedented Telehealth Support through the Omnibus Appropriations and Coronavirus Relief Spending Bills.
The Mental Health Telemedicine Expansion Act was introduced to the House by Ms. Suzan DelBene in February of 2019 to amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of certain mental health telehealth services. On December 21, 2020, as the incoming Chair of the New Democrat Coalition, Ms. DelBene explained that the bill was designed to expand telehealth access for seniors seeking mental health care.
The bill amends title XVIII of the Social Security Act to provide for coverage under the Medicare program of certain mental health telehealth services. The entirety of the official bill can be found on the congress website. Key sections of the most relevance to the telehealth community are reproduced here for your convenience. It reads as such:
“SEC. 2. MEDICARE COVERAGE OF CERTAIN MENTAL HEALTH TELEHEALTH SERVICES.
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended—
(1) in paragraph (4)(F)(i), by inserting “services identified by CPT codes 90834 and 90837 (and as subsequently modified by the Secretary),” before “and any additional service”; and
(2) by adding at the end the following new paragraph:
“(8) TREATMENT OF MENTAL HEALTH TELEHEALTH SERVICES.—
“(A) NON-APPLICATION OF ORIGINATING SITE REQUIREMENTS.—The requirements described in paragraph (4)(C) shall not apply with respect to telehealth services furnished on or after January 1, 2020, that are mental health telehealth services. Nothing in the previous sentence shall waive any applicable State law requirements.
“(B) INCLUSION OF CERTAIN SITES.—With respect to telehealth services described in subparagraph (A), the term ‘originating site’ shall include the home of the eligible telehealth individual at which the individual is located at the time the service is furnished via a telecommunications system.
“(C) NO ORIGINATING SITE FACILITY FEE.—No facility fee shall be paid under paragraph (2)(B) to an originating site with respect to a telehealth service described in subparagraph (A) if the originating site does not otherwise meet the requirements for an originating site under paragraph (4)(C).
“(D) IN-PERSON ASSESSMENTS REQUIRED.—Payment may not be made for mental health telehealth services under this paragraph (if such payment would not otherwise be allowed under this subsection without application of this paragraph) furnished to an eligible telehealth individual unless—
“(i) prior to the provision of such mental health telehealth services, a physician or practitioner furnished an in-person assessment of the needs of such individual for such services; and
“(ii) a physician or practitioner furnishes a reassessment of the needs of such individual for such services at a frequency specified by the Secretary.
“(E) MENTAL HEALTH TELEHEALTH SERVICES DEFINED.—For purposes of this paragraph, the term ‘mental health telehealth service’ means services identified by CPT codes 90834 and 90837 (and as subsequently modified by the Secretary).”.
Editorial comment by Telehealth.org: While the bill does not go as far as many members of the telehealth community would have hoped, it is a notable step toward the goal of allowing telehealth to be available to all American citizens who can benefit. We at Telehealth.org extend a heartfelt “thank you” to the legislators who made this happen. We encourage others to come to look at the data supporting telebehavioral health in all areas of behavioral care.
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