H. R. 1301
IN THE HOUSE OF REPRESENTATIVES
February 15, 2019
Ms. DelBene introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of certain mental health telehealth services.
This Act may be cited as the
Mental Health Telemedicine Expansion Act.
Medicare coverage of certain mental health telehealth services
Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended—
in paragraph (4)(F)(i), by inserting
services identified by CPT codes 90834 and 90837 (and as subsequently modified by the Secretary), before
and any additional service; and
by adding at the end the following new paragraph:
Treatment of mental health telehealth services
Non-application of originating site requirements
The requirements described in paragraph (4)(C) shall not apply with respect to telehealth services furnished on or after January 1, 2020, that are mental health telehealth services. Nothing in the previous sentence shall waive any applicable State law requirements.
Inclusion of certain sites
With respect to telehealth services described in subparagraph (A), the term originating site shall include the home of the eligible telehealth individual at which the individual is located at the time the service is furnished via a telecommunications system.
No originating site facility fee
No facility fee shall be paid under paragraph (2)(B) to an originating site with respect to a telehealth service described in subparagraph (A) if the originating site does not otherwise meet the requirements for an originating site under paragraph (4)(C).
In-person assessments required
Payment may not be made for mental health telehealth services under this paragraph (if such payment would not otherwise be allowed under this subsection without application of this paragraph) furnished to an eligible telehealth individual unless—
prior to the provision of such mental health telehealth services, a physician or practitioner furnished an in-person assessment of the needs of such individual for such services; and
a physician or practitioner furnishes a reassessment of the needs of such individual for such services at a frequency specified by the Secretary.
Mental health telehealth services defined
For purposes of this paragraph, the term mental health telehealth service means services identified by CPT codes 90834 and 90837 (and as subsequently modified by the Secretary).