COVID Public Health Emergency (PHE) to End May 11th
by Barbara Griswold (Feb 12, 2023)
The Biden Administration has announced their intent to end the federal COVID-19 public health emergency (PHE) on May 11, 2023. Now in place for over three years, the PHE led to almost universal expansion of telehealth coverage. So now many of us are panicking.
Does the end of the PHE mean our clients will lose telehealth coverage? Unfortunately, the answer to this question is “it depends.” Whether your client will lose coverage — and whether telehealth will be paid at the same rate as in-person — may depend on your state, the telehealth policy of your client’s health plan, whether the client’s specific account covers telehealth, whether you are in- or out of network with the client’s plan, and whether you are doing phone sessions (out-of-network sessions and phone sessions are probably the most vulnerable to coverage cuts).
I know, I wish I had more clarity for you. And I promise a more detailed article in a future newsletter. But I can promise, my advice will be the same: You need to contact the insurance plan for each client to confirm continued coverage for the services you are providing. Remember, one client from a health plan may have telehealth coverage, and another may not. And carefully read your Explanation of Benefits (the claim processing details), looking for coverage changes.
Overall, I believe we have reason to be optimistic. My guess is that most of our clients will not be affected by the ending of the PHE. I don’t predict that plans will go back to the Dark Ages before telehealth for mental health was covered. It is too popular with clients. Medicare has generally embraced it (more on that in that future article). Also, I think plans would find it difficult to take away any benefit their members have enjoyed for three years. Even legislators see how telehealth has increased access to underserved populations. So stay tuned for a future article for more on this topic….. (if you aren’t subscribed to my free monthly email newsletter, subscribe here)