Telehealth Billing Changes for Coming in 2022

The onset of COVID-19 caused most major insurance carriers to suddenly not only allow telehealth, but to reduce the restrictions. Telehealth has been around for years, but is clearly much more common today. With COVID-19 settling into somewhat of a norm now, we are seeing that insurances are starting to change the rules regarding telehealth. Even though telehealth was utilized in almost every area of medicine, the mental health community definitely was one of the largest specialties providing telehealth services. Patients receiving mental health treatment prior to COVID couldn’t just stop, and COVID brought on the need for many others to being treatment. While providers across the nation were forced to close their office doors, mental health providers scrambled to find a way to continue treatment for their patients. Telehealth was the best option.

Medicare recently announced some billing changes for 2022. According to the new rule, effective January 1, 2022CMS will require providers to use a new POS code for services provided to patients by telehealth while the patient is in their home. The following are the POS codes for telehealth services effective January 1, 2022.

POS code 02 – is for Telehealth Services Provided Other than in the Patient’s HOme.

POS code 10 – is for Telehealth Provided in the Patient’s Home

POS code 10 does not apply if the patient is in a hospital, skilled
nursing facility, or assisted living facility. It only applies if the
patient is receiving the services from their home.

The Office of the Inspector General of the US Department of Health and
Human Services recently released a data snapshot that showed that most
Medicare beneficiaries (78%) who received telehealth health services
from a psychologist had an established relationship with that provider
prior to receiving telehealth services. But several Medicare
beneficiaries (22%) began treatment with a psychologist through
telehealth without having an established in person relationship. It is
possible that the rules may change in the future requiring at least one
in person meeting in a certain time frame in order to receive telehealth

The expansion of telehealth services has been essential to maintaining
access to care for many patients during this pandemic. It is something
that I believe will always be present in healthcare going forward. But
the rules will continue to be revised as time goes on. We must keep up
to date with all information pertaining to telehealth. We will continue
to report any changes as we become aware of them.