Telepsychiatry and the End of the COVID-19 PHE
The Biden Administration announced last week that the COVID-19 public health emergency (PHE) will end on May 11, 2023. What does this mean for mental health care after three years of delivering care under a number of flexibilities? To find out more details, read on, and please see APA’s FAQ, "What Happens when the Public Health Emergency Ends? Telepsychiatry & Hybrid Practice Post-PHE", COVID-19 Telehealth Policies Wind-down Timeline, and a Psych News article, "Biden Announces End of COVID Public Health Emergency in May".
Most importantly for many APA members, as Shabana Khan, M.D., shares in the below video, the Ryan Haight Act’s restriction on telehealth prescribing of controlled substances goes back into effect immediately when the PHE ends. DEA-registered practitioners will also once again need a DEA registration in any state in which they are prescribing controlled substances (such as stimulants or benzodiazepines). Dr. Khan advises APA members to start planning now to provide continuity of treatment to any patients you have never seen in person or any that live in a state in which you don’t have a DEA registration.
Other PHE flexibilities are also on their way out. Some notable items that will return to their pre-PHE status include: practitioners will be required to use HIPAA-compliant communications technologies; Medicare Part B providers will no longer be able to bill Medicare for services provided in any state, but only in states in which they are licensed; and Medicaid continuous eligibility is being phased out at the federal level, so Medicaid enrollment numbers will decrease in most states.
Some telehealth flexibilities are here to stay, at least for now. A requirement to provide in-person care to Medicare members before initiating telehealth services has been delayed until December 31, 2024, and Medicare coverage of audio-only mental health services is permanent.
Remember, many of the policies that affect your telepsychiatry practice on a day-to-day basis are based on state, local, or private actions. Since the majority of state public health emergencies and associated licensure flexibilities have already ended, you need to be licensed or registered in any state you’re delivering care. Private and Medicaid coverage of telehealth services vary. Keep in touch with your APA District Branch, state medical board, and other trusted advisors to understand policy and practice in your situation.