Mental Health Coverage Gets More Available for Medicare Beneficiaries

In 2022, people with Medicare will have improved access to mental health telehealth services. It means that Medicare enrollees can get help for mental health issues through video or telephone calls with a doctor. 

What You Need to Know about Medicare Telehealth Services in 2022

Telemedicine post-pandemic has increased in demand, and as a result, Medicare has expanded access to Medicare telehealth services for its beneficiaries.

As of 2022, Medicare has 270 services covered, with 160 still temporarily approved until the end of the pandemic.

These Category 3 codes are temporary designations created by the Centers for Medicare and Medicaid Services (CMS) in 2020 for telehealth services during public health emergencies. They are not covered by Medicare permanently as of now, but permanent inclusion may be considered in the future if there’s sufficient data to back it up after 2022. Medicare enrollees can use the Category 3 codes until December 2023.

Virtual Check-in Codes

CMS also created the Communication Technology-Based Services (CTBS) to provide video and phone call coverage. The codes are used to help patients access telehealth services for medical assessment that is non-emergent but requires more detailed evaluation. At-risk patients can avoid unnecessary office visits while still getting the same benefits of in-person consultations.

The new CTBS codes, G2012 for audio and G2010 for videos and images, will be used for check-ins that last between five and 10 minutes. These are intended to be used when the clinician and patient have an established relationship, and the interaction is unrelated to a new problem or diagnosis. Medicare coinsurance and deductibles will still apply.

Geographic Restrictions

The CAA has finally removed a geographic restriction allowing for home services as originating sites in diagnosing, evaluating, and treating mental disorders.

For this rule to apply, the patient must have received an in-person visit within six months after initial telehealthcare services with at least one face-to-face meeting every 12 throughout therapy.

Medicare Part B and Telehealth Benefits

Medicare Part B covers outpatient care, including doctor visits, preventive services, durable medical equipment, home health care, and telehealth. By 2022, Medicare Part B has skyrocketed to $170 per month from its rate of $148.50 in 2021. Additionally, the increase in Part B deductible went to $233. Some factors for the premium increase are COVID coverage, uncertainties with increased spending on Aduhelm (a medication for Alzheimer’s pending approval under Part B), and the short-term spending bill.

Telehealth services are also expanding, with counseling available across the country. Medicare enrollees can now access counseling and therapy services (substance use disorders are also covered under this plan). Moreover, it also covers those who want to access the service with limited Internet coverage. 

Medicare is changing the rules of mental health coverage to allow for visits outside of pandemic restrictions. Phone calls and online chats provided by rural clinics, including FQHCs (Federally Qualified Health Centers), will be covered under Medicare’s standard guidelines starting in 2022.

Coverage of Telehealth Services

The new Medicare telehealth services in 2022 will cover:

– Alcohol and substance abuse counseling

– Psychiatric diagnostic interview examinations

– Psychotherapy for crisis

– Family counseling for mental health

– Patient education and training

Medicare’s expansion of telehealth services is a much-needed change that will help many Americans get the care they need. 

Work With a Reliable Medicare Advisor

Finding the best advisor to guide you with all this information about Medicare is essential. With the right help, you can be assured that you’re getting the most out of your coverage and taking advantage of all available opportunities. Medicare plans are constantly changing, so it’s crucial to have someone by your side who can keep you up to date on all the latest news.