Payment & Reimbursement

This web resource shares the basics of telehealth policy across the nation, including actions and exceptions introduced in the 2020 CARES Act to help expand the use of telehealth during the pandemic.

This best practices guide provides resources and tips focused using telehealth for behavioral health care.

The purpose of this document is to provide guidance to addiction treatment clinicians and programs on the regulatory and general practice issues related to the use of telehealth during the COVID-19 national emergency, which is also a public health emergency.

The CY 2021 Medicare Physician Fee Schedule Final Rule was placed on display at the Federal Register on December 2, 2020. This final rule updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2021. This final rule updates policies affecting the calculation of payment rates and includes misvalued codes. It also adds services to the telehealth list including a third temporary category for services added under the PHE, as well as certain other revisions to telehealth services.

The Centers for Medicare and Medicaid Services is responding to the opioid epidemic by promoting safe and responsible pain management, making sure patients can access treatment for opioid use disorder, and using data to target prevention and treatment.

Starting January 1, 2020, under the Calendar Year (CY) 2020 Physician Fee Schedule final rule the Centers for Medicare & Medicaid Services will pay Opioid Treatment Programs through bundled payments for opioid use disorder treatment services in an episode of care provided to people with Medicare Part B (Medical Insurance).

In the Calender Year 2020 Physician Fee Schedule final rule, the Centers for Medicare and Medicaid Services included new coding and payment for a monthly bundle of services for the treatment of opioid use disorder that includes overall management, care coordination, individual and group psychotherapy, substance use counseling, and add-on code for additional counseling. This is a way for clinicians to bill for a group of services in the office setting similar to the services covered under the Opioid Treatment Program benefit for clinics.

Provides guidance to clinicians and practices on using telehealth for substance use services during COVID-19, including benefits of using telehealth, Federal and State policy changes, private payers, and general considerations

Explains topics related to billing Medicare and Medicaid for telehealth services, such as billing codes, policies, and application during COVID-19