Medicare Telehealth Changes for 2022
The CY 2022 MPFS Final Rule indicated that Section 123 of the CAA removed the geographic restrictions and added the home of the beneficiary as a permissible originating site for telehealth services furnished for the purposes of diagnosis, evaluation, or treatment of a mental health disorder.
This change also requires for these services that there must be an in-person, non-telehealth service with the physician or practitioner within six months prior to the initial telehealth service. CR 12519 further established that there must be an in-person, non-telehealth service every 12 months thereafter.
The final rule also finalized a requirement for the use of a new modifier for services furnished using audio-only communications, which would serve to verify that the practitioner had the capability to provide two-way, audio/video technology, but instead, used audio-only technology due to beneficiary choice or limitations. The rule also indicated that mental health services can include services for SUDs.
On 1/14/2022, CMS also issued CR 12549 that implements the specific modifiers for use in these situations. Those modifiers are:
- FQ – A telehealth service was furnished using real-time audio-only communication technology; and,
- FR – A supervising practitioner was present through a real-time two-way, audio/video communication technology.
These modifiers will be implemented in the Medicare processing system on 4/4/2022 with an effective date of 1/1/2022. Please make note of these modifiers to properly use them once they are implemented.
Related Content
- MLN Matters® Article: MM12519: Summary of Policies in the Calendar Year (CY) 2022 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List
- MLN Matters® Article: MM12549: CY2022 Telehealth Update Medicare Physician Fee Schedule
Reviewed 11/16/2023