Sec. 103. Medicare coverage of certain mental health telehealth services
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/bill/116/hr/3417/rh/section-103·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m) ) is amended— in paragraph (2)(B)(i), by striking and paragraph (6)(C) and inserting , paragraph (6)(C), and paragraph (8)(C) ; in paragraph (4)(C)(i), by striking and
(7)and inserting (7), and
(8); in paragraph (4)(F)(i), by inserting services identified by CPT codes 90832, 90834, and 90837 (and as subsequently modified by the Secretary), before and any additional service ; in paragraph (6)(A), by striking paragraph (4)(C) and inserting paragraph (4)(C)(i) ; in paragraph (7), by striking The geographic requirements and inserting Subject to paragraph (8)(D), the geographic requirements ; and by adding at the end the following new paragraph: The requirements described in paragraph (4)(C)(i) shall not apply with respect to telehealth services furnished on or after January 1, 2021, that are mental health telehealth services. Nothing in the previous sentence shall waive any applicable State law requirements. With respect to telehealth services described in subparagraph (A), the term originating site shall include the home of the eligible telehealth individual at which the individual is located at the time the service is furnished via a telecommunications system. No facility fee shall be paid under paragraph (2)(B) to an originating site with respect to a telehealth service described in subparagraph
(A)if the originating site does not otherwise meet the requirements for an originating site under paragraph (4)(C). Payment may not be made for mental health telehealth services under this paragraph (if such payment would not otherwise be allowed under this subsection without application of this paragraph or paragraph (7)) furnished to an eligible telehealth individual unless— within the 6-month period prior to the provision of such mental health telehealth services, the individual receives a face-to-face clinical assessment, without the use of telehealth, by a physician described in subparagraph (F)(i) or a practitioner described in subparagraph (F)(ii) of the needs of such individual for such services; and the individual receives a reassessment (at a frequency specified by the Secretary) by a physician so described or a practitioner so described of the needs of such individual for such services. For purposes of this paragraph, the term mental health telehealth service means services identified by CPT codes 90832, 90834, and 90837 (and as subsequently modified by the Secretary). For purposes of subparagraph (D): A physician described in this clause is a physician, as defined in section 1861(r)(1). A practitioner described in this clause is a practitioner described in any of clauses (i), (iv), or
(v)of section 1842(b)(18)(C). .
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Sec. 103
Medicare coverage of certain mental health telehealth services
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