Instructions

Please copy the sample talking points below, then go to the action tool and paste them in the comment field. Once pasted, please feel free to personalize the text to reflect how the proposed rule would affect you, your patients, and/or the community where you live, serve, or work. If you wish to return to the action center from this page, click here.

Deadline to Comment: September 13, 2021

Combined Comments:

I support the telehealth provisions in this Proposed Rule that would continue to help patients from underserved communities— e.g. rural areas and communities of color—to access these services, often for the first time. Tele-mental and tele-behavioral health also increase access for people with disabilities’ by addressing challenges including lack of transportation and anxiety during appointments.

The availability of audio-only telehealth is particularly beneficial to many older patients who may lack the familiarity with technology necessary for an audio/video telehealth appointment.

I thank CMS for the flexibility extended during the pandemic, such as making the home an originating site, enabling coverage of more services via telehealth, and allowing patients to use audio-only devices. 

CMS should make these changes permanent, and make further efforts to close gaps in access to mental and behavioral health services. Audio-only coverage should also be expanded to include behavioral health services. Like psychotherapy, Health Behavior Assessment and Intervention (HBAI) services (codes 96156-96171) do not require patient visualization, making them fit for telehealth visits, including audio-only, to patients in their homes. 

Feedback sessions for psychological and neuropsychological testing evaluation (96130 – 96133) should also be available as audio-only services. 

An in-person visit is not needed to successfully provide mental / behavioral health services through telehealth, including audio-only. If CMS is forced to establish an interval for subsequent in-person visits, it should be at least 12 months. 

I support CMS’ proposal to allow Psychological and Neuropsychological Testing furnished via telehealth to remain covered until the end of 2023, allowing time to address CMS’ concerns and protecting beneficiaries from losing access to critical services when the PHE ends. 

CMS should place Developmental Testing services (96112 & 96113) and Adaptive Behavior & Treatment (97151, 97152, 0362T, 97153, 97154, 97155, 97156, 97157, 97158 and 0373T) on the interim telehealth services list until the end of 2023 to give stakeholders more time to demonstrate their effectiveness. 

Since private payers often base coverage decisions on Medicare policies, adding code 90849 for multiple family group psychotherapy to the telehealth list even if it is not covered in Medicare will support access to these critically important services to patients who are not Medicare beneficiaries. 

I support the proposal by CMS to continue coverage of telehealth and audio-only services in RHCs and FQHCs. Medicare beneficiaries in these facilities should have the same access to mental / behavioral health services as those treated by providers practicing independently. 

All telehealth services, including audio-only, must be reimbursed at the same rate as in-person services, at the non-facility rate. Paying less for telehealth services will discourage their use by providers and threaten beneficiary access.

CMS should adopt codes 989x1-989x5 for remote therapeutic monitoring (RTM). Psychologists provide non-physiologic services through RTM and must be allowed to bill Medicare under these codes. Reimbursement under the new RTM codes should be the same as for the remote physiological monitoring (RPM) codes that the RTM series was designed to resemble. 

I appreciate CMS’s consideration of new reimbursement policies for chronic pain management services. CMS should increase Medicare patient access to psychological pain management services, such as making psychologists independently reimbursable for pain management assessments, care planning and consultation, and patient services. 

CMS should work with Congress to avoid the losses clinicians will incur if budget neutrality requirements must be met in 2022. The projected 3.89% loss for 2022 follows a 3.3% reduction in 2021 for budget neutrality. With this newest reduction in the conversion factor Medicare providers will have lost almost 7% in payment from 2020 to 2022. Such a cut will put beneficiary access to critical services in jeopardy.