Medicare to Expand Access to Behavioral Health and Substance Abuse

Medicare to Expand Access to Behavioral Health and Substance Abuse

Last week the Centers for Medicare and Medicaid Services (CMS) finalized policies aimed at expanding access to behavioral health and substance use disorder treatment services for Medicare beneficiaries in rural areas.

Starting Jan. 1 of next year, the annual Medicare physician payment rule and Medicare hospital outpatient and ambulatory surgical centers rule will do the following:

  • Make it easier for addiction counselors, family therapists and others to offer services, particularly in rural areas.
  • Make a pandemic-era flexibility permanent that allows hospital outpatient departments to bill for in-home tele-behavioral health services.
  • Extend Medicare coverage to include opioid treatment programs that initiate the prescribing of buprenorphine — a medication-assisted treatment — via tele-health. Medicare will also cover such services provided through mobile units.
  • Other provisions include new monthly payments for comprehensive treatment and management services for patients with chronic pain, as well as expanded access to certain cancer-screening coverage and dental care.

In addition, CMS will offer enhanced Medicare payments to incentivize hospitals to purchase N95 respirators manufactured in the United States, in an effort to sustain domestic production of the masks for future public health emergencies.