On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) finalized the Medicare Physician Fee Schedule for 2024. APA submitted a letter to CMS in September 2023 (APA Responds to CMS' Proposals Regarding Improving Access to and Quality of Medicare Services in the 2024 Medicare Physician Fee Schedule and Quality Payment Program) in response to the draft rule, and many of the finalized elements are aligned with APA’s recommendations.

If you’re an APA member, please feel free to watch the recording of our November Policy & Practice Insights Series session on this topic.

Key telepsychiatry elements of the 2024 Medicare Physician Fee Schedule include, through 2024:

• Outpatient telemedicine: CMS has extended their current temporary policy to reimburse outpatient telepsychiatry in the patient’s home (which is defined to include temporary lodgings or other community-based settings) (POS 10) at the same rate as in-person care. Telehealth services provided in facility settings, including in outpatient provider-based departments (POS 02), will be adjusted to be reimbursed at the lower facility rate.
• Virtual supervision: CMS accepted APA’s recommendation to maintain virtual supervision of trainee physicians in all geographic locations after significant advocacy. Through 2024, resident physicians may be virtually supervised – via live video modalities – when the resident is delivering telehealth. Residents are not able to be virtually supervised when delivering in-person care outside of rural areas.
• Home address: Medicare practitioners may continue to report their practice location instead of home address when providing telehealth services from their homes.
• Additional allowed services:
  • Audio-only delivery of periodic assessments in opioid treatment programs.
  • Telehealth services delivered by FQHCs or RHCs without a prior in-person visit.

Please note that all of these flexibilities are currently extended just through 2024, which aligns with telehealth flexibility extensions put in place by the Consolidated Appropriations Act of 2023 (Medicare Telemental Health Care Beyond the Public Health Emergency: Changes APA Advocated for in the Physician Fee Schedule). The Drug Enforcement Administration (DEA) has also extended flexibilities around telemedicine prescribing of controlled substances through the end of 2024, aligning regulatory timelines.

Telehealth policies will be up for debate in 2024 across agencies and branches of government to establish permanent policy in 2025 and beyond.

Please recall that state, payer, facility, and other private policies can vary and affect practice. You should always follow your best clinical judgment and provide in-person care when needed.