Policy

Policy

State Telehealth Policy Resources

We maintain informational resources on telehealth policies for states in our region. Click the links below or in the navigation bar above.

Medicare (Federal) Telehealth Policy

CMS 2022 Policy Changes & CY 2022 PFS

Audio-only telehealth for mental health care services

AUDIO-ONLY services are allowed for mental health (including SUD services) as long as:

  • The patient has an in-person visit within six months prior to telehealth & an in-person service at least once within 12 months of each subsequent telehealth service (unless geographic restrictions are met allowing the service to be delivered via telehealth

  • Opioid Treatment Programs (OTPs) can use audio-only to furnish therapy and counseling when live video is not available to beneficiary after the PHE is over

  • NOTE: The requirement for an in-person prior to an audio-only appointment is suspended for the duration of the PHE.

All of the services that can be delivered via audio-only telemedicine in 2022 are here. Nearly all codes available for audio-only in 2020 are available for audio-only in 2022 (expiring December 31, 2023).

The previous telehealth restrictions limiting mental health services to be only available to patients residing in rural areas will no longer apply. Per the 2021 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, these services can be delivered to patients in a home setting.

Other telehealth services

Medical nutrition therapy (MNT) and diabetes self-management training (DSMT) services may be provided as telehealth services when registered dietitians or nutrition professionals act as distant site practitioners.

Category 3 services introduced during the PHE will remain until December 31, 2023:

  • Domiciliary, Rest Home, or Custodial Care Services, Established Patients (99336, 99337)

  • Home Visits, Established Patient (99349, 99350)

  • Emergency Department Visits, Levels 1-5 (99281-99385)

  • Nursing Facilities Discharge Day Management (99315, 99316)

  • Psychological and Neuropsychological Testing (96130-96133, 96136-96139)

  • Therapy Services, Physical, Speech/Hearing, and Occupational Therapy, All levels (97161-97168; 97110, 97112, 97116, 97535, 97750, 97755, 97760, 97761, 92521-92524, 92507)

  • Hospital Discharge Day Management (99238-99239)

  • Inpatient Neonatal and Pediatric Critical Care, Subsequent (99469, 99472, 99476)

  • Continuing Neonatal Intensive Care Services (99478-99480)

  • Critical Care Services (99291-99292)

  • End-Stage Renal Disease Monthly Capitation Payment codes (90952, 90953, 90956, 90959, 90962)

  • Subsequent Observation and Observation Discharge Day Management (99217, 99224-99226)

  • CMS also is extending the inclusion of certain outpatient cardiac rehabilitation, and intensive cardiac rehabilitation codes (CPT codes 93797 and 93798, and Healthcare Common Procedure Coding System (HCPCS) codes G0422-G0423) through the end of CY 2023.

CMS finalized permanent adoption of coding and payment for extended virtual check-ins (HCPCS code G2252). These services allow audio-only interactions to be used for a longer medical discussion to determine the necessity of an in-person visit.

5 new Remote Therapeutic Monitoring/Treatment Management (RTM) codes (98975-98977, 98980-98981)

5 new CPT codes added to the CCM code family (99437, 99424-99427)

Additional gpTRAC Policy Resources

Other Telehealth Policy Resources

NETRC Telehealth Library

Health Center Clearinghouse

Federal Telehealth Website

Rural Health Information Hub

National Consortium of Telehealth Resource Centers