Recently, ACA submitted comments in response to the Centers for Medicare and Medicaid Services (CMS) issued Physician Fee Schedule (PFS) proposed rule released earlier this summer. ACA’s response to the proposed echoes the proposals to expand access to behavioral health services, including the inclusions of marriage and family therapists (MFTs) and licensed professional counselors (LPCs) to provide behavioral health services while being under general supervision rather than direct supervision.
Summary of ACA’s Comments to Proposed Rule:
Eligible Practitioners: ACA clarifies state licensing requirements and requests flexibility of post-degree clinical supervised experience. ACA noted that the Counseling Compact will require the Compact Commission to establish a uniform supervised post-graduate professional experience requirement moving forward.
Telehealth: ACA supports the proposals recognition of MHCs as telehealth practitioners, as a vehicle to increase participation in services, especially for Medicare beneficiaries.
Diagnostic Tests: CMS proposed to amend regulations to include MHCs as practitioners who can order diagnostic tests, according to allowed State laws. ACA recognizes MHS’s use of diagnostic test.
Addiction Counselors: ACA highlights CMS’ proposal to allow Addiction Counselors who meet all the requirements for MHCs to also enroll in Medicare as MHCs.
General Behavioral Health Integration (BHI) Services: ACA supports the revisions to allow MHCs as one of the eligible providers to bill for BHI services as part of primary care team.
Health Behavior Assessment and Intervention (HBAI) Services: Earlier this year, ACA met with CMS to request MHCs be able to bill for HBAI services, which was included in CMS recently proposed rule.
Hospice Interdisciplinary Teams: ACA notes different types of support that may be needed and provided by MHCs in Hospice.
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): Beginning January 1, 2024, MHCs are eligible practitioners to furnish Part B services at RHCs and FQHCs.
Mobile Crisis Services: ACA anticipates these licensed practitioners will be eligible for separate Medicare reimbursement for providing mobile crisis services as part of a team.
Merit-Based Incentive: CMS did not include any proposals for this. ACA requested that CMS consider and address the participation of such practitioners under the QPP.
ACA will continue to work with CMS as we move closer to implementation beginning January 1, 2024. Please follow this link to read ACA’s full response.
For more information or if you have any questions regarding the CMS PFS, you can contact the ACA Government Affairs and Public Policy team at email@example.com.