The Centers for Medicare & Medicaid Services’ (CMS) proposed 2024 Medicare Physician Fee Schedule could expand behavioral health coverage, boost care coordination and increase rates for providers.
Specifically, the proposed changes would allow marriage and family therapists (MFTs) and mental health counselors (MHCs), including substance use disorder counselors, to enroll in Medicare and bill for their services. CMS announced the proposed changes late Thursday.
The agency’s proposal also aims to boost integration by allowing certain practitioners to bill for integrated behavioral health services in a primary care setting.
“CMS continues to demonstrate commitment to advancing health equity and building a stronger Medicare program,” Dr. Meena Seshamani, CMS deputy administrator and director of the Center for Medicare, said in a statement. “If finalized, the proposals in this rule ensure the people we serve experience coordinated care focused on treating the whole person, considering each person’s unique story and individualized needs — physical health, behavioral health, oral health, social determinants of health, and are inclusive of caregivers, which are all so important to providing the care that people with Medicare deserve.”
The new proposal also allows clinical social workers, MFTs and MHCs to use health behavioral assessment and intervention codes, which were historically only used by psychologists.
Part of the proposal also boosts the valuation of behavioral health services and increases rates. It requires the secretary of the U.S. Department of Health and Human Services (HHS) to establish a new code for crisis psychotherapy delivered at the site of service.
“This rule contains some of the most important changes to improve access to behavioral health in Medicare in the program’s history,” CMS noted in its announcement.
The proposal also seeks to extend the telehealth flexibilities allowing audio-only communication for opioid treatment programs (OTPs).
“We believe extending these flexibilities by an additional year (through CY 2024) may promote continued beneficiary access for these services by minimizing potential disruptions to services due to the end of the COVID-19 PHE,” CMS wrote in a fact sheet.
More information on CMS’ proposed 2024 Medicare Physician Fee Schedule is available here.
CMS additionally announced a proposal to expand access to behavioral health services through coverage of intensive outpatient services on Thursday.
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