April 6, 2020
The Centers for Medicare and Medicaid Services (CMS) recently implemented temporary flexibilities in regulations regarding telehealth in order to ensure that beneficiaries can access health and mental health services during the COVID-19 public health emergency. Clinical social workers can use smartphones with video chat apps such as Skype or Apple Facetime, in addition to video conferencing technology (which was permissible prior to the pandemic), to conduct psychotherapy. However, Medicare will not reimburse for psychotherapy provided via audio-only devices (e.g. landlines).
Many Medicare beneficiaries either do not have access to smartphones, do not know how to use video chat capability, or do not have adequate, reliable internet service to support video communications. With stay at home orders and physical distancing likely to be required for many weeks and months, and with research showing the severe adverse effects of social isolation and loneliness, Medicare beneficiaries need to be able to connect easily with mental health providers, including CSWs. A number of states as well as commercial health plans are allowing the use of audio-only devices; Medicare needs to do the same.
The Mental Health Caucus of the U.S. House of Representatives on April 3 sent a letter to HHS Secretary Alex Azar and CMS Administrator, Seema Verma, to urge the agency to include audio-only access as a telehealth flexibility for psychotherapy. Sen. Edward Markey (D-MA) has also urged CMS to remove this barrier.