Apply telehealth flexibilities to HBAI services

Parity, Coverage, & Equitable Access
Topics
No items found.
social determinants of health
No items found.
Population
Older Adults
People with Physical Disabilities
Coverage & Standards
Telehealth
Medicare
Parity/Treatment Limitations
Federal department
No items found.
house committees
House Energy and Commerce Committee
House Ways and Means Committee
senate committees
Senate Finance Committee

Recommendation

Congress should clarify that permanent Medicare telehealth flexibilities for mental health services under the Consolidated Appropriations Act 2021 also apply to health and behavior assessment and intervention (HBAI) services, which are provided to help individuals with chronic conditions deal with psychological obstacles to improved health and adherence to treatment regimes.[1]

Background/summary

Health and behavior assessment and intervention (HBAI) services are billable Current Procedural Terminology (CPT) codes to address psychological obstacles for those with primarily physical chronic health conditions.[2] Effective treatment of chronic physical health conditions can be impeded when psychological or emotional factors affect a patient’s ability to adhere to prescribed treatment, making HBAI an important part of comprehensive disease management. Psychologists are able to assess patients on the same day as receiving physical health services, and this is known to improve quality-of-life outcomes and medication adherence.[3]

Teletherapy utilization increased sharply during the initial months of the COVID-19 pandemic. While telehealth utilization has decreased slightly from pandemic peaks, it has remained strong for mental health and substance use disorder (MH/SUD) treatment.[4] Telehealth services for MH/SUD treatment can improve access as providers are able to serve more geographically dispersed populations, and can help alleviate provider shortages in underserved areas.

In 2021, the Consolidated Appropriations Act (CAA) made permanent flexibilities for the delivery of MH/SUD telehealth services.[5][6] Because HBAI services are designed to address the psychological and emotional needs of patients with physical health conditions, Congress should also clarify that recent changes in Medicare to facilitate the provision of telehealth services also applies to HBAI services.[1]

citations

1. Senate Finance Committee. 2022. “SFC Bipartisan Mental Health Care Provisions”. Last Accessed May 26, 2022.

2. American Psychological Association. Health Behavior Assessment and Intervention Services. Last Updated November, 2022.

3. American Psychological Association. Health Behavior Assessment and Intervention CPT Codes for Psychologists. Last Accessed July 20, 2023.

4. Department of Health & Human Services Office of Health Policy. 2022. Updated National Survey Trends in Telehealth Utilization and Modality. Last Updated April 19, 2023.

5. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. Telehealth policy changes after the COVID-19 public health emergency. Last Updated July 17, 2023.

6. Morris, Manning & Martin, LLP. Mental Health Parity Expansion: Health Plans Must Comply With New Documentation Requirements. Last Updated October 28, 2021.