Announcement of Expanded Telehealth Coverage from BCBSMA and MPA's Continued Telehealth Advocacy
Wednesday, April 13, 2016
Announcement of Expanded Telehealth Coverage from
BCBSMA and MPA's Continued Telehealth Advocacy
Dear MPA Members,
MPA is pleased to announce that our advocacy has resulted in Blue Cross Blue Shield of Massachusetts (BCBSMA) expanding the services that will be allowed via telehealth to include all psychotherapy codes that they currently reimburse for face-to-face services. BCBSMA representatives have stated in no uncertain terms that this change was brought about as the result of MPA's advocacy on the issue. This is a significant improvement from the initial policy BCBSMA implemented, and we are encouraged by this imminent change in policy.
In a recent MPA member survey, we asked you the following question: "Looking ahead to the next three to five years, how concerned are you about telehealth services delivery?" 29 percent of respondents were "very concerned" and 25 percent of respondents were "concerned".
In recent years MPA has been focused on influencing telehealth implementation on your behalf. While most psychologists do not currently provide telehealth services, some speculate that the majority will within the next five years. As health plans and policymakers rapidly set policies impacting the practice of telepsychology, MPA believes that a proactive advocacy approach will protect our members and those we serve for years to come.
In fall 2015 BCBSMA announced new policies to cover psychological services provided by video-conferencing means (telehealth). However, their policy limited services to Diagnostic Evaluations (90791) and Psychotherapy for 30 minutes or less (90832), and they reported cutting the "practice expense" portion of the rates for services in a manner resulting in significant reductions in reimbursement for telehealth services relative to face-to-face services. MPA believed that these policies undermined consumers' access to the most effective and appropriate services.
After our initial attempts at direct and collaborative advocacy with BCBSMA failed to result in an adequate response, MPA mounted a rapid and comprehensive advocacy approach. This approached involved our legal counsel, consultation with APA Practice Organization's Legal and Regulatory Affairs staff as well as communications with multiple state regulators.
BCBSMA recently informed us that they plan to change their policy to include coverage for all psychotherapy codes by videoconferencing that they currently reimburse on an in-person basis. This change will likely be announced in detail by BCBSMA June 1st, and implemented July 1st this year.
While we are pleased to report this successful outcome as an incremental improvement on the current BCBSMA policy, the fact that the practice expense formulas have not yet been revised is a fundamental flaw in their rate-setting process for telehealth. As we explained in our recent letter to the Joint Committee on Healthcare Finance, MPA believes that when psychologists that maintain brick-and-mortar practices provide face-to-face services, the additional provision of psychological services via videoconferencing results in higher practice expenses. We continue to seek a change to BCBSMA's flawed rate-setting process and seek reimbursement for telehealth at rates that are at least the same rates as in-person rates.
We will keep you informed on this issue as well as the broader changes in telehealth, as we continue to advocate for positive implementation of telehealth policies with BCBSMA and other health plans, including advocating for passage of telehealth legislation that would require reimbursement parity between telehealth and face-to-face services, as articulated in our above-referenced letter to the Joint Committee on Healthcare Finance.
Thank you for your continued membership and participation in MPA. We hope that you will encourage all of your colleagues to join MPA so that we can strengthen our advocacy mission.
MPA Executive Director
Michael Goldberg, Ph.D.
MPA Director of Professional Affairs