Advocacy & Policy Updates (2022)
APA 2023 Physician Fee Schedule Final Rule (12/28/22)
Changes to reimbursement for mental and behavioral health services are included in the final rule on the 2023 Medicare Physician Fee Schedule, released on November 1, 2022 by the Centers for Medicare and Medicaid Services (CMS). Psychologists—who submitted 12,000 comments to CMS on the proposed rule issued in July 2022—can now see how their efforts to advocate for the profession impacted the agency’s decision making. Read the full article here:
https://www.apaservices.org/practice/reimbursement/government/help-psychologists-meet-need
HIEA and NC HealthConnex (12/21/22)
(Previously published in the APC Update of July 20):
Within the North Carolina budget passed by Governor Cooper in July, there is language suggesting that no state funds will be withheld from any provider or entity who does not submit data to the Health Information Exchange (HIE) until a new law designating a lead enforcement agency is passed. Previously, providers had a deadline of January 1, 2023 to take action by signing a Participation Agreement with the NCHIE. It is not clear when such a new law will be passed, but it will likely not be any sooner than March 31, 2023 (the deadline for the HIE Advisory Board report noted below).
Please see the HIEA language excerpts below:
SECTION 9B.3.(a) By March 31, 2023, the North Carolina Health Information Exchange Advisory Board shall submit a report on the statewide health information exchange network (HIE Network) known as NC HealthConnex to the Joint Legislative Oversight Committee on Health and Human Services. The report shall include at a minimum:
(1) An update regarding the connectivity status of providers and entities required by G.S. 90-414.4 to connect to and submit data through the HIE Network. This update shall be based on an analysis conducted by the North Carolina Health Information Exchange Authority, with assistance as necessary from the Department of State Treasurer, State Health Plan Division, and the Department of Health and Human Services, Division of Health Benefits.
(2) As a supplement to the recommendations provided pursuant to Section 7(a) of S.L. 2021-26, additional recommendations regarding appropriate features or actions, including legislative or administrative proposals, to support enforcement of the Statewide Health Information Exchange Act and enhancement of the HIE Network.
SECTION 9B.3.(b) Notwithstanding any provision of Article 29B of Chapter 90 of the General Statutes or any other provision of law to the contrary, connecting to and submitting data through the HIE Network known as NC HealthConnex shall not be a condition precedent to the receipt of State funds, including Medicaid funds, by any provider or entity subject to subsection (b) of G.S. 90-414.4 until a bill designating a lead agency responsible for enforcement of the Statewide Health Information Exchange Act is enacted into law.
SECTION 9B.3.(c) This section is effective when it becomes law.
See the full budget here: The HIEA language is on page 66.
Additional information for psychologists:
HIEA October 2022 update: https://hiea.nc.gov/blog/2022/10/28/nc-hiea-october-2022-update
FAQ page: https://hiea.nc.gov/frequently-asked-questions
Connection Deadline FAQs: https://hiea.nc.gov/faqs/connection-deadline-faqs
**Action Needed to Prevent 2023 Medicare Payment Cuts** (12/21/22)
Please ask Congress today to protect Medicare from consequential cuts. Without Congressional action, reimbursement rates for all providers will decrease 4.5% in January.
Why is this important? This affects access to mental health services because cuts to Medicare rates make it hard for providers to accept Medicare beneficiaries. The payment cuts also have ripple effects for everyone else. That is because Medicare’s reimbursement rates strongly influence Medicaid and private insurance reimbursement rates. Medicare payment rate cuts for mental and behavioral health services should not be happening in the midst of a mental health crisis!
Why are these cuts happening? Current law requires that the annual updates to the Medicare fee schedule for physician and other provider services be “budget neutral,” and to meet this requirement the Centers for Medicare and Medicaid Services (CMS) annually adopts a single, across-the-board adjustment in payment rates affecting all providers. This required adjustment—in the “conversion factor” within the payment formula—often results in Medicare provider reimbursement rates failing to keep pace with inflation. However, for the last two years, CMS has scheduled noticeably larger reductions in the conversion factor to account for new, higher payments proposed for evaluation and management services provided by physicians.
How has Congress helped in the past? Thankfully, Congress has responded in each of the last two years by stepping in to zero out CMS’s across-the-board reductions in Medicare payment rates. House and Senate members from both parties are working to prevent the 4.5% cut from taking place, but we need them to hear from constituents to keep this at the top of their priority list for year-end legislation.
We need Congress step in again – please take 2 minutes to ask to prevent these cuts!
APA is part of a large coalition of health care provider organizations pushing for the inclusion of language to prevent the 4.5% reduction in the Medicare fee schedule conversion factor from taking effect in January. Our recent coalition letter—with over 100 organizations signing on—is online at: coalition letter
PsyPact (12/14/22)
Click here to view the State Board contact page, including links to state laws, rules, and regulations.
PsyPact (12/14/22)
Click here to view the sample language for how to list the APIT and/or TAP in email signatures, vitaes, etc. (from the FAQs)
APA (12/7/22)
Securing critical wins for psychology in final Medicare Physician Fee Schedule rule - Click here
Advocating for comprehensive mental health reform - Click here
BCBSNC (11/30/22)
Click here to view additional information about the Telehealth Policy for 2023
Medicare (11/30/22)
Physician Fee Schedule Part B
Click here and use this tool to display or download fees effective January 2023.
ASPPB (11/23/22)
The Centre for Data and Analysis on Psychology Licensure
Annual Report on Psychology Licensure Requirements in the United States and Canada -
Read the full report here.
APA (11/16/22)
APA appoints six new members of the Advocacy Coordinating Committee - Click here to view.
The Trust (11/16/22)
The Trust Advisor Newsletter - Read the quarterly newsletter here.
NC Medicaid: Fee Schedule and Covered Code Portal (11/9/22)
As of November 3, all fee schedules currently listed on the NC Medicaid website have been moved to a new Fee Schedule and Covered Code Portal available to the public. The new website offers enhanced search options for fee schedules, covered procedure codes and covered revenue code data. These enhancements include:
- Fee Schedules – (NC Medicaid Website Fee Schedules Only)
- Fee schedules are available in a formatted, standardized template
- A single link is available to download all current and archived fee schedule files
- A single link is available to access a new lookup tool that allows users to search for fee schedule data using filters
- Covered Procedure Code Combinations and Covered Revenue Code Documents
- These documents are housed on a new website accessible to Health Plans and Providers
- A single link allows users to download each of the covered procedure code combinations and covered revenue code files
- A single link is available to access a new lookup tool to search for covered procedure code combinations data and covered revenue code data using filters
Please review the User Guide for additional information on navigating the new Fee Schedule and Covered Code Portal.
All fee schedule data created prior to Nov. 3, 2022, will remain on the current NC Medicaid website. Please refer any questions to the NC Medicaid Contact Center at 888-245-0179.
NCHIEA (11/9/22)
NC HealthConnex Teletown Hall: Year in Review and What's New for 2023
Click here to register for the November 16 virtual townhall.
BCBSNC (11/9/22)
New Provider Credentialing and Enrollment Process Change effective November 1, 2022.
Click here to read.
Brighton Health Plan Solutions to Administer Benefits for Select Blue Cross NC Employer Groups effective January 1, 2023. - Read more here.
Blue Cross NC and Mindoula to Expand Access to Mental Health Care - Click here to view.
NC HIEA (11/2/22)
October 2022 Update - Click here to read
World Professional Association for Transgender Health (WPATH) (11/2/22)
Standards of Care (Version 8, Updated 2022) - Click here to read
APA (10/26/22)
No Surprises Act: CMS looks for input on good faith estimate requirements - Click here to read.
NC Psychology Board (10/26/22)
Click here to read the Fall Newsletter, The Bulletin Board
PsyPact Commission (10/26/22)
Click here to read the October newsletter
PHE (10/19/22)
National PHE was renewed on October 13
Click here to read the declaration.
BCBSNC (10/19/22)
Click here for Telehealth information including a list of reimbursable telehealth services
Click here for the Corporate Reimbursement Policy for Telehealth which includes detailed list of CPT codes (beginning page 6)
Click here to read the Update: Delays for Enrolling New Providers
Association of State and Provincial Psychology Boards (ASPPB) (10/12/22)
The Centre for Data and Analysis on Psychology Licensure -
Click here for the Annual Report on Psychology Licensure Requirements in the United States and Canada
APA (10/12/22)
What Psychologists Should Know About 988 - Click here to read
BCBSNC Releases Data on Telehealth Usage During COVID-19 (10/5/22)
- New policy builds on usage data, covers 97% of pandemic telehealth claims
- Compared to the pre-pandemic policy, members will have access to 77 more telehealth services under the new policy, effective Jan. 1, 2023
Click here to read the press release.
Health Information Exchange Authority (NCHIEA) (10/5/22)
July 2022 Legal Update (initially run in the August 3 APC Update)
- State Legislature Temporarily Suspends Enforcement Provision in the Statewide Health Information Exchange Act
- January 1, 2023, Deadline to Connect to NC HealthConnex Remains Unchanged
Click here to read the full article.
APA (9/28/22)
No Surprises Act: APA awaits new rule on good faith estimates - Click here to view.
BCBSNC (9/21/22)
Notice of Pricing Development and Maintenance Policy Updates for BETOS/CCS, 2008 Pricing Policy and Non-2008 Pricing Policy - Click Here
New Provider Credentialing and Enrollment Process Change Effective November 1, 2022 -
Click Here
Care Affiliate Enhancements Effective September 2022 - Click Here
APA Services (9/21/22)
Psychology Advocacy Network Action Alert:
Why is this bill important?
This legislation repeals the discriminatory Defense of Marriage Act (DOMA), enshrines and shores up marriage equality in federal law, and provides additional legal protections for marriage equality. It does so by codifying the federal protections conferred by the Supreme Court of the United States in the Loving, Windsor, and Obergefell rulings. These landmark decisions stated that bans on marriage equality, bans on interracial marriage, and denial of federal marriage benefits are unconstitutional. The House of Representatives passed the bill with a strong bipartisan vote of 267-157. The bill could be considered by the Senate as early as next week. The voice of psychologists on this urgent piece of legislation will be critical as the bill moves to the Senate for a vote.
Research has shown that marriage provides substantial psychological and physical health benefits due to the moral, economic, and social support extended to married couples. Conversely, empirical evidence has illustrated the harmful psychological effect of policies restricting marriage rights for same-sex couples.
Following the U.S. Supreme Court’s decision in Dobbs to overturn Roe v. Wade, opponents are feeling emboldened to try and reverse other fundamental rights, including marriage equality. Please join us today to call on the Senate to defend marriage equality for same-sex and interracial couples.
DSM-5-TR (9/14/22)
American Psychiatric Association - Click here to view the DSM-5-TR Fact Sheets
Message from the NC Psychology Board (9/14/22)
The NC Psychology Board has opened license renewal.
From the desk of Daniel Collins, Executive Director of the NC Psychology Board. . .
Given the additional requirements for this year’s license renewal and the delayed opening of the online renewal system, the North Carolina Psychology Board has determined to waive the late renewal fee for this renewal only.
As a result, licensees will have until November 30, 2022 to renew their licenses without paying a late fee or having the status of their licensees affected. As a result, licenses renewed after October 1, 2022, but by November 30, 2022 will still be considered current and valid. The licenses do not “expire” if not renewed by October 1, 2022; however, licenses not renewed by November 30, 2022 will be suspended.
You must complete the State Ethics Refresher before you renew your license. If you have not taken the State Ethics Refresher, you must log into the NC Psychology Board Licensee renewal webpage to do so.
You must upload all your continuing education documentation to CE Broker by October 1. The grace period does not apply to supplying your continuing education documentation within the CE Broker system.
Should you have any questions about this matter, you may direct them to the Board office at info@ncpsychologyboard.org or (828) 262-2258.
Click here to view the official letter.
APA Services - APASI Issues "Cease and Desist" Letter to CareDash For Using Shadow Profiles (9/7/22)
After receiving reports from members, APA Services, Inc. took action to stop CareDash from creating online profiles for psychologists without their consent. Instead of allowing prospective patients to schedule appointments with the psychologists listed in the profiles, patients were redirected to make appointments on online therapy platforms or other networks of competing providers. Bloomberg interviewed psychologists about discovering shadow profiles for their practice on CareDash. APA encourages members listed on CareDash without their consent to file complaints with the Federal Trade Commission, their state’s consumer protection office, or the Better Business Bureau.
BCBS - Updates to Telehealth Policy Through the End of 2022 (8/31/22)
Click here to view the updates to telehealth policy through the end of 2022.
State Health Plan Budget Changes and Health Information Exchange Act Update (8/31/22)
Click here to view the state health plan budget changes and Health Information Exchange Act update.
APA Evaluate your website for ADA Compliance (8/24/22)
Evaluate your website for ADA Compliance - Click here to view
ADA Guidance on Web Accessibility and the ADA (8/24/22)
Guidance on Web Accessibility and the ADA - Click here to view
Covid-19 and Healthcare Providers (8/24/22)
On August 15, Governor Roy Cooper lifted the North Carolina Covid-19 State of Emergency.
Click here to read the press release.
The NC Department of Health and Human Services (NCDHHS) website states that "Masks are still required in places like health care and long-term care. This is because of the setting or federal regulations."
Click here to see the mask guidance page.
While this guidance may change in the future, this is the current NCDHHS information.
Advocate Today! Submit a Message to the Biden Administration Regarding the CMS Proposed Rule on the CY 2023 Physician Fee Schedule (8/24/22)
The annual Physician Fee Schedule rule has serious implications across the health care field – to researchers, clinicians, educators, and students alike. It often sets the benchmark for how other insurance programs cover and reimburse for specific services and sets the standard for how new and emerging forms of treatment are covered. Compared to previous years, this year’s Physician Fee Schedule proposed rule has a particular focus on mental and behavioral health. This means that all representing the fields of psychology and behavioral health have a unique opportunity to elevate psychologists’ voice and the key role they play in mental health treatment.
This year's proposal has consequential provisions which need improvement, including:
- Needing to recognize the importance of providing training based in psychological science to behavioral caregivers, to improve outcomes for people with disabilities, behavioral disorders, and more.
- Creation of new service codes that must be revised to reflect the services performed by and the contributions of psychologists and psychological science.
It also has positive provisions which might not become reality unless you speak up for them, including:
- Giving psychologists flexibility to participate in treatment teams through evidence-based models of integrated care.
- Expanding access to and coordination of mental health services in rural and underserved areas by enhancing the psychology workforce.
- Expanding and preserving access to telehealth services beyond the COVID-19 public health emergency.
Let's beat our number of comments from last year; we need at least 310 comments! See how North Carolina currently ranks against other states below.
Click here to easily submit your message!
PSYPACT - Public Comment on Proposed Rules (8/17/22)
The PSYPACT Commission has released two proposed rules. The Commission will accept public comment until September 27, 2022 at 5:00pm EST. To submit public comment, please visit this link: https://psypact.site-ym.com/page/PublicComment
The annual Commission meeting which will contain a public hearing regarding these rules will be held on November 17th, 2022 at 11:00am EST. A registration link for this meeting can be found on the website page above.
PSYPACT News (8/17/22)
Click here to view this page. It includes links to newsletters and public statements from the PSYPACT Commission.
The Trust - Student and Early Career Resources (8/10/22)
Click here to view Student and Early Career Resources
APA - American Psychological Association of Graduate Students (APAGS) (8/10/22)
Click here to view the American Psychological Association of Graduate Students (APAGS)
APA Services - ECP Column (8/10/22)
Click here to view the ECP column.
APA Updated Guidelines (8/3/22)
The Guidelines for Assessment and Intervention with Persons with Disabilities were adopted by the APA Council of Representatives in February 2022 and replace the original Guidelines for Assessment of and Intervention with Persons with Disabilities from 2011.
APA Open Comment Period for Proposed Revisions to 4 APA Practice Guidelines (7/27/22)
The 60-day public comment period for the following four (4) Professional Practice Guidelines are open.
- Guidelines for the Practice of Telepsychology
- Guidelines for the Practice of Parenting Coordination
- Guidelines Regarding Psychologists’ Involvement in Pharmacological Issues
- Guidelines for Psychological Evaluations in Child Protection Matters
Call for Comments: Proposed Revision for Guidelines for the Practice of Telepsychology (7/27/22)
In accordance with Association Rule 30.8, the Board of Professional Affairs (BPA) and Committee on Professional Practice and Standards (COPPS) seek member and public comments on the Proposed Revision for Guidelines for the Practice of Telepsychology.
These guidelines were developed by a cross-group collaborative and are intended to educate and guide psychologists using technology in their practices. We welcome your input, suggestions and commentary on the guidelines and key issues in this important area of professional practice. See Comment Form Instructions for more details on specific areas for input. Overarching comments are also welcome.
Link to Comment: https://apps.apa.org/CommentCentral2/Default.aspx?site=102
Deadline for Comments (60 Day Public Comment Period): August 30, 2022
Call for Comments: Proposed Revision for Guidelines for the Practice of Parenting Coordination (7/27/22)
In accordance with Association Rule 30.8, the Board of Professional Affairs (BPA) and Committee on Professional Practice and Standards (COPPS) seek member and public comments on the Proposed Revision for Guidelines for the Practice of Parenting Coordination.
These guidelines were developed by a cross-group collaborative and are intended to provide a specific framework and direction for psychologists for professional conduct and decision making in the practice of parenting coordination. We welcome your input, suggestions and commentary on the guidelines and key issues in this important area of professional practice. See Comment Form Instructions for more details on specific areas for input. Overarching comments are also welcome.
Link to Comment: https://apps.apa.org/CommentCentral2/Default.aspx?site=101
Deadline for Comments (60 Day Public Comment Period): August 30, 2022
Call for Comments: Proposed Revision for Practice Guidelines Regarding Psychologists' Involvement in Pharmacological Issues (7/27/22)
In accordance with Association Rule 30.8, the Board of Professional Affairs (BPA) and Committee on Professional Practice and Standards (COPPS) seek member and public comments on the Proposed Revision for Practice Guidelines Regarding Psychologists’ Involvement in Pharmacological Issues.
These guidelines were developed by a cross-group collaborative and are intended to provide a resource to psychologists interested in the issue of what represents optimal practice in relation to pharmacotherapy. We welcome your input, suggestions and commentary on the guidelines and key issues in this important area of professional practice. See Comment Form Instructions for more details on specific areas for input. Overarching comments are also welcome.
Link to Comment: https://apps.apa.org/CommentCentral2/Default.aspx?site=100
Deadline for Comments (60 Day Public Comment Period): August 30, 2022
Call for Comments: Proposed Revision of Guidelines for Psychological Evaluations in Child Protection Matters (7/27/22)
In accordance with Association Rule 30.8, the Board of Professional Affairs (BPA) and Committee on Professional Practice and Standards (COPPS) seek member and public comments on the Proposed Revision of Guidelines for Psychological Evaluations in Child Protection Matters.
These guidelines were developed by a cross-group collaborative and are intended to provide relevant, professionally sound results or opinions in matters where a child’s health and welfare may have been and/or may be harmed. We welcome your input, suggestions and commentary on the guidelines and key issues in this important area of professional practice. See Comment Form Instructions for more details on specific areas for input. Overarching comments are also welcome.
Link to Comment: https://apps.apa.org/CommentCentral2/default.aspx?site=58
Deadline for Comments (60 Day Public Comment Period): August 30, 2022
Public Health Emergency (PHE) Extended (7/20/22)
Please click here to read the renewal of determination that a public health emergency exists.
Update: NC HealthConnex (7/20/22)
Governor Cooper signed the budget into law on Monday, July 11th. Within the budget, there is language suggesting that no state funds will be withheld from any provider or entity who does not submit data to the Health Information Exchange (HIE) until a new law designating a lead enforcement agency is passed. Previously, providers had a deadline of January 1, 2023 to take action by signing a Participation Agreement with the NCHIE. It is not clear when such a new law will be passed, but it will likely not be any sooner than March 31, 2023 (the deadline for the HIE Advisory Board report noted below). There is currently no other information available from the Health Information Exchange Authority (HIEA).
Please see the HIEA language excerpts below:
SECTION 9B.3.(a) By March 31, 2023, the North Carolina Health Information Exchange Advisory Board shall submit a report on the statewide health information exchange network (HIE Network) known as NC HealthConnex to the Joint Legislative Oversight Committee on Health and Human Services. The report shall include at a minimum:
(1) An update regarding the connectivity status of providers and entities required by G.S. 90-414.4 to connect to and submit data through the HIE Network. This update shall be based on an analysis conducted by the North Carolina Health Information Exchange Authority, with assistance as necessary from the Department of State Treasurer, State Health Plan Division, and the Department of Health and Human Services, Division of Health Benefits.
(2) As a supplement to the recommendations provided pursuant to Section 7(a) of S.L. 2021-26, additional recommendations regarding appropriate features or actions, including legislative or administrative proposals, to support enforcement of the Statewide Health Information Exchange Act and enhancement of the HIE Network.
SECTION 9B.3.(b) Notwithstanding any provision of Article 29B of Chapter 90 of the General Statutes or any other provision of law to the contrary, connecting to and submitting data through the HIE Network known as NC HealthConnex shall not be a condition precedent to the receipt of State funds, including Medicaid funds, by any provider or entity subject to subsection (b) of G.S. 90-414.4 until a bill designating a lead agency responsible for enforcement of the Statewide Health Information Exchange Act is enacted into law.
SECTION 9B.3.(c) This section is effective when it becomes law.
Click here to review the entire budget. The HIEA language is on page 66.
APA Audio-only Telehealth: How to maintain privacy and security (7/13/22)
A new resource from the Department of Health and Human Services helps providers comply with HIPAA while providing audio-only services. Click here for the full article.
APA CMS Physician Fee Schedule (7/13/22)
The physician fee schedule proposed rule—released annually between June and August and followed by a 60-day comment period—outlines the agency’s new proposed polices, suggested changes to services, and provider payments for the coming year. After reviewing the public comments, CMS releases a final rule in November explaining which proposed changes will become final and take effect for the next calendar year. Click here for the full article.
988 Suicide and Crisis Lifeline (7/13/22)
988 goes live on all devices on July 16, 2022:
USDHHS information: https://www.samhsa.gov/find-help/988
FCC Information: https://www.fcc.gov/suicide-prevention-hotline
PsyPact (7/6/22)
Click here to view the current map of PsyPact states.
Click here to see the PsyPact Commission newsletters.
Telehealth Certification Institute (7/6/22)
States' TeleMental Health Laws, Rules, and Regulations: View here.
The Trust: Telepsychology Competencies Credential (TCC) (7/6/22)
Introducing the Telepsychology Competencies Credential – an educational platform brought to you by The Trust and the National Register that enables providers to achieve proficiency in the most common elements of telepsychological practice.
Click here to read more.
APA Private Practice Helpline (6/29/22)
The Private Practice Helpline for APA members is an exclusive benefit to assist members seeking information regarding the business aspects of private practice. Click here to read more.
APA Division 52 International Psychology (6/22/22)
Division 52 Document: Licensing Guidelines Around the World (6/22/22)
BCBS Providers Invited to Join NC State Health Plan Network (6/15/22)
Click here to read the details.
North Carolina Psychologist Privilege License (6/15/22)
According to the NC Psychology Board, "a psychologist who engages in the professional art of healing (as defined) for a fee or reward is subject to...This license, issued as "psychologist" privilege license, is in addition to the regulatory license required by the North Carolina Psychology Board." Click here to read the Full Statement.
The Privilege License Tax is a $50.00 annual fee, due July 1.
Click here to view the NC Department of Revenue (NCDOR) page about the Privilege License Tax.
Click here for the NCDOR page with the tax forms and instructions.
Medicare Billing for Telehealth (6/8/22)
. NCPA has been receiving questions about billing Medicare for telehealth services. Specifically, members who switched to using a POS other than 11 (such as POS 10, patient at home) are reporting being paid at a lower rate. Here are some updated resources:
CMS update May 27
https://www.cms.gov/files/document/mm12427-newmodifications-place-service-pos-codes-telehealth.pdf
Health and Human Services (HHS) update May 17
Place of Service codes and modifiers
When billing telehealth claims for services delivered on or after January 1, 2022, and for the duration of the COVID-19 emergency declaration:
- Include Place of Service (POS) equal to what it would have been had the service been furnished in person.
- Medicare hasn’t identified place of service modifier 10 (PDF) for use when the patient is in their home. If they are located in any other location, utilize place of service modifier 02.
- Append modifier 95 to indicate the service took place via telehealth
The CR modifier is not required when billing for telehealth services.
Full HHS article here:
The public health emergency (PHE) has been extended to July 15 (and is expected to be renewed again). Based on the information above, it appears that when billing Medicare, providers should continue to bill POS 11 (office) and modifier 95 (to indicate a telehealth service) during the PHE.
At this point, it is not clear what the CMS policy will be regarding reimbursement rates for telehealth services beyond the pandemic. APA has stated:
APA will advocate for all telehealth services to continue to be paid at the same rate as in-person services once the PHE ends. Before the PHE, CMS paid for telehealth services at the facility rate, which is lower than the nonfacility rate paid for outpatient office visits.
https://www.apaservices.org/practice/reimbursement/government/telehealth-after-pandemic
BCBS
Providers Invited to Join NC State Health Plan Network (6/8/22)
Click here to read the details.
BCBS Annual Provider Training and Attestation Requirements (6/1/22)
BCBS Annual Provider Training and Attestation Requirements - Click here.
Action Alert - Advocate for Telehealth Services in NC (6/1/22)
NCPA is a member of the Professional Association Council (PAC).
The Professional Association Council (PAC) is providing information to our association members to contact their North Carolina Senators to help advocate for telehealth services. House Bill 149 Increase Access to Telehealth would improve telehealth coverage for all health benefit plans offered by the state. It seeks to (1) guarantee coverage to a health care service or procedure regardless of whether it is offered in-person or through telehealth. (2) Reimburse provider-to-provider consultations conducted through telehealth as long as the health benefit plan would have reimbursed the consultation had it happened in-person. (3) The health benefit plan may require a co-payment for a health care service or procedure delivered through telehealth, however, it cannot exceed the co-payment amount had the service been provided in-person. (4) No health benefit plan can require prior authorization for health care services through telehealth if prior authorization is not required had the service been in-person. (5) There cannot be any limits on the originating site or the distant site for the delivery of telehealth services. (6) Lastly, the bill clarifies that telehealth services cannot be used for anything related to abortion except in the case of an emergency therapeutic abortion (this is already state law).
This legislation passed the House in May 2021. We are asking providers to email their Senator in the North Carolina General Assembly and communicate their success stories from serving clients via telehealth during the current pandemic and to support House Bill 149. It is our desire, after hearing from many providers, the Senate will also pass House Bill 149 after realizing the importance that telehealth has played in this past year.
Providers, please remove the highlighted sections below and edit this letter to best suit your practice experience/client needs.
Find your North Carolina Senator here: https://www.ncleg.gov/FindYourLegislators
Enter your address and then select NC House and Senate (NOT US House). When it pulls up the results, you can click on the name of your North Carolina Senate member to get their email address to send the letter to.
A suggested subject line for the email: From your Constituent – Support HB 149 to Improve Access to Care Through Telehealth
Dear Senator insert last name,
My name is _____________ and I am a ___________ Licensed Psychologist I work in your county with a specialty population _____ (more about this population- aging, youth, opioid, etc).
If you have a story to share about providing telehealth services, particularly if you are in a rural area, insert that story here.
I am writing to request that you work to support HB 149 which would enact many of the same telehealth standards that many insurance companies are currently using since the pandemic.
Telehealth has particular efficacy in and application to the provision of mental health. The ability to provide telehealth services has resulted in fewer cancellations, greater therapeutic value as clients are more comfortable with the counseling process in their own homes than my office, and a greater access to care in general. Because counseling does not involve physical examinations, we have been able to provide the same quality of care as if we were doing an in person visit. Most of my clients have expressed satisfaction with telehealth services and want to continue those services.
I am applying the same skill and educational level to telehealth visits as I would an in person visit. Therefore, reimbursement for such services should be paid the same as an in person visit, and subject to the same coverage and copays, all as provided in HB 149.
Without the passage of HB 149, insurance companies will begin to rollback telehealth policies and thus limit access to behavioral health services that many of my patients have come to need and any abrupt end to telehealth policies will be disruptive to the care I provide.
Providers, feel free to share more about your experience without providing telehealth care.
I appreciate your consideration. Thank you for your service to our community and to our great State.
Sincerely,
Provider Name, Credential
The National Psychologist (5/25/22)
The National Psychologist is an online source of news and information designed for practicing psychologists who want to keep up on their profession.
Action Alert (5/18/22)
NCPA is a member of the Professional Association Council (PAC).
The Professional Association Council (PAC) is providing information to our association members to contact their North Carolina Senators to help advocate for telehealth services. House Bill 149 Increase Access to Telehealth would improve telehealth coverage for all health benefit plans offered by the state. It seeks to (1) guarantee coverage to a health care service or procedure regardless of whether it is offered in-person or through telehealth. (2) Reimburse provider-to-provider consultations conducted through telehealth as long as the health benefit plan would have reimbursed the consultation had it happened in-person. (3) The health benefit plan may require a co-payment for a health care service or procedure delivered through telehealth, however, it cannot exceed the co-payment amount had the service been provided in-person. (4) No health benefit plan can require prior authorization for health care services through telehealth if prior authorization is not required had the service been in-person. (5) There cannot be any limits on the originating site or the distant site for the delivery of telehealth services. (6) Lastly, the bill clarifies that telehealth services cannot be used for anything related to abortion except in the case of an emergency therapeutic abortion (this is already state law).
This legislation passed the House in May 2021. We are asking providers to email their Senator in the North Carolina General Assembly and communicate their success stories from serving clients via telehealth during the current pandemic and to support House Bill 149. It is our desire, after hearing from many providers, the Senate will also pass House Bill 149 after realizing the importance that telehealth has played in this past year.
Providers, please remove the highlighted sections below and edit this letter to best suit your practice experience/client needs.
Find your North Carolina Senator here: https://www.ncleg.gov/FindYourLegislators
Enter your address and then select NC House and Senate (NOT US House). When it pulls up the results, you can click on the name of your North Carolina Senate member to get their email address to send the letter to.
A suggested subject line for the email: From your Constituent – Support HB 149 to Improve Access to Care Through Telehealth
Dear Senator insert last name,
My name is _____________ and I am a ___________ Licensed Psychologist I work in your county with a specialty population _____ (more about this population- aging, youth, opioid, etc).
If you have a story to share about providing telehealth services, particularly if you are in a rural area, insert that story here.
I am writing to request that you work to support HB 149 which would enact many of the same telehealth standards that many insurance companies are currently using since the pandemic.
Telehealth has particular efficacy in and application to the provision of mental health. The ability to provide telehealth services has resulted in fewer cancellations, greater therapeutic value as clients are more comfortable with the counseling process in their own homes than my office, and a greater access to care in general. Because counseling does not involve physical examinations, we have been able to provide the same quality of care as if we were doing an in person visit. Most of my clients have expressed satisfaction with telehealth services and want to continue those services.
I am applying the same skill and educational level to telehealth visits as I would an in person visit. Therefore, reimbursement for such services should be paid the same as an in person visit, and subject to the same coverage and copays, all as provided in HB 149.
Without the passage of HB 149, insurance companies will begin to rollback telehealth policies and thus limit access to behavioral health services that many of my patients have come to need and any abrupt end to telehealth policies will be disruptive to the care I provide.
Providers, feel free to share more about your experience without providing telehealth care.
I appreciate your consideration. Thank you for your service to our community and to our great State.
Sincerely,
Provider Name, Credential
NC State Health Plan Accepting New CPP Providers (5/11/22)
The NC State Health Plan Network will be accepting new Clear Pricing Project (CPP) providers for the 2023 benefit year. Providers will be able to join beginning June 1, 2022, through June 30, 2022. Click here for more information.
APA Services Working On A New Legislative Approach (5/11/22)
Dear Colleagues:
We are sharing a request from APA Services – they need your stories! APA Services is working on a new legislative approach to establishing independent practice authority throughout Medicare. They are collecting stories from psychologists in outpatient rehabilitation facilities, skilled nursing facilities, partial hospitalization programs, home health services, and hospice programs. If you work in those settings, please take a few minutes to explain how physician referral and authorization requirements affect access to your services and patient outcomes. Share your stories today!
Your anecdotes about how the inconsistent and outdated physician authorization requirements get in the way of patient care will help connect policymakers to the issues on a human and personal level, and illustrate why they should support changing current law. If you have any questions about the legislative proposal, please contact Scott Barstow, Senior Director of Congressional and Federal Affairs. APA Services will be collecting stories until Memorial Day, May 30.
APA Services: Let's Get Technical (5/4/22)
Click here for a review of the latest apps and tools for practicing psychologists.
Online Toolkit (5/4/22)
NCPA members at the Investor level and above have access to the Online Practice Toolkit.
This Toolkit contains resources covering 24 major content areas, such as Insurance, Legal, Licensure, Record Keeping, Professional Wills, Retirement, Sample Forms and Policies, Technology and PsyPact, and much more. The Patient Resources section contains numerous suggestions for books, Ted Talks, websites, and podcasts that psychologists may wish to use in their practice.
The Toolkit is updated consistently by the Advocacy and Practice Committee (APC).
Blue Cross and Blue Shield North Carolina Survey (5/4/22)
We are gathering information about provider experiences with Blue Cross Blue Shield North Carolina (BCBSNC). Please click below to complete the survey.
Blue Cross and Blue Shield North Carolina Survey (4/27/22)
We are gathering information about provider experiences with Blue Cross Blue Shield North Carolina (BCBSNC). Please click below to complete the survey.
National Law Review Medicare telehealth waivers extended past PHE (excerpts from April 18, 2022 publication) (4/20/22)
On March 15, President Biden signed into law H.R. 2471, the “Consolidated Appropriations Act, 2022”, which extends many of the Medicare telehealth flexibilities put in place during the COVID-19 pandemic for a period following the end of the Public Health Emergency (PHE). The same day, the Office of Inspector General (OIG) issued a report highlighting the positive impact telehealth had on increasing access for beneficiaries during the first year of the pandemic. Then, during a press conference on March 18, the Department of Health & Human Services (HHS) Secretary Xavier Becerra said that HHS will seek to sustain and expand access to telehealth services after the PHE ends. While these developments signal the continued expansion of telehealth, there is still some uncertainty surrounding coverage, reimbursement and licensure flexibilities that have allowed telehealth to flourish for the past two years.
The “Consolidated Appropriations Act, 2022” included a number of provisions related to Medicare coverage of telehealth services. Specifically, the following Medicare waivers will be extended for 151 days following the end of the PHE:
- Originating Site: Allows Medicare beneficiaries to receive telehealth services from any geographic location, including their home.
- Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs): Allows FQHCs and RHCs to continue providing telehealth services.
- In-person Requirement for Mental Health: Waives the requirement for mental health providers to see patients in person prior to providing behavioral health services via telehealth.
- Audio-only: Allows Medicare coverage of audio-only services when appropriate.
- These extensions will give Congress the opportunity to pass the Telehealth Extension and Evaluation Act, or otherwise make the flexibilities permanent, or alternatively, give providers time to prepare for a return to in-person care.
Optum Update on COVID-19 Telehealth Flexibilities (4/6/22)
Please be aware of this recent update to temporary telehealth flexibilities related to the COVID-19 pandemic. These flexibilities are applicable for UnitedHealthcare members:
• Commercial Membership - for in-network providers, expanded telehealth flexibilities have recently been extended through June 15, 2022, unless otherwise mandated by the state. These telehealth exceptions are now set to end effective June 16, 2022.
Providers are encouraged to confirm member benefits and coverage provided by their specific health plan at the time of service due to the rapidly changing situation.
For the most current information regarding COVID-19 flexibilities, please be sure to visit Provider Express. There, you'll find more detailed information, along with links to other sites, including:
• State-specific COVID-19 resources
• Other Health Plan partners' sites
We greatly appreciate your continued efforts in helping members and our communities during this health emergency.
Cigna (4/6/22)
"Billing a POS 02 for virtual services may result in reduced payment or denied claims. Billing a typical face-to-face place of service (e.g., POS 11) will ensure providers receive the same reimbursement as they typically get for a face-to-face visit."
Click here to read more.
The Trust (3/30/22)
How to Be a Good Supervisor - Click Here
How to Be a Good Supervisee - Click Here
The Trust (3/23/22)
Continuing Professional Development (CPD) Plans
Please help us Advocate Effectively: Complete BCBSNC Survey (3/16/22)
We are gathering information about provider experiences with Blue Cross Blue Shield North Carolina (BCBSNC). Click here to complete the brief survey.
Blue Cross Blue Shield of North Carolina will extend the telehealth policy until September 30, 2022. (3/10/2022)
Click here to read more.
NC Psychology Board - Continuing Education Reference Guide (3/9/2022)
Click here to view.
The Trust - Sample Informed Consent Forms Page (3/9/2022)
Includes forms for Walk and Talk therapy and Returning to In-Person Services.
Click here to view.
APA - ABCs and 123s of Encryption (3/9/2022)
Click here to view.
BCBS Extends Telehealth Policy Through March 31, 2022 (3/9/2022)
Click here to view.
Multi-Discipline Licensure Resource Project (MDLR) (3/2/22)
“The Multi-Discipline Licensure Resource Project (MDLR) is brought to you by the Association of State and Provincial Psychology Boards (ASPPB) as part of a Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) grant initiative. In May 2020, HRSA awarded ASPPB federal funding to help provide support for the 2020 Coronavirus Aid, Relief and Economic Security Act (CARES). ASPPB received grant funding to support the Licensure Portability Grantee Program in preventing, preparing for and responding to the coronavirus disease 2019 (COVID-19), including through telehealth access and infrastructure.”
APA
Understanding the No Surprises Act: How to Provide Estimates for your Services (Updated February 23, 2022)
APA (2/2322)
Medicare Advantage Plans: What Psychologists Need to Know
Click here to read
What to Know About Doing Telehealth in a Different State
Click here to read
DSM-5 Revisions (2/16/22)
From the Psychiatry Online website:
“Significant changes—including the addition of prolonged grief disorder and the inclusion of symptom codes for suicidal behavior and nonsuicidal self-injury, refinement of criteria, and comprehensive literature-based updates to the text—will appear in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), to be released by American Psychiatric Association Publishing in March.”
APA (2/16/22)
Telehealth and POS codes
Recent changes in CMS guidance for telehealth regarding the in-person visit requirement and place of service codes - Click here to view
Office of Legal and State Advocacy
“The Office of Legal and State Advocacy (LSA) assists members with health insurance and managed care issues. Our staff experts work collaboratively with insurers, when possible, to smooth out troublesome billing, audit, and claims practices. LSA also collaborates with state psychological associations to pursue government agency complaints and lawsuits that challenge abusive practices by health insurance and managed care companies.”
Click here for LSA information and resources related to Insurance and Managed Care
The Trust- FAQs about the NSA- Updated January 31, 2022 (2/9/22)
No Surprises Act and Good Faith Estimates- Write to your Legislative Representatives (2/9/22)
The APA, in conjunction with ten other national organizations, has sent a letter asking Health and Human Services (HHS) to exempt mental health professionals from the requirements of the No Surprises Act and its GFE mandate. Psychologists are encouraged to contact your legislative representatives personally to ask for their support in this effort.
Click here to find your legislators.
You can also do an internet search for "contact Senator XXX" or "Contact Rep. XXX" to send an email to each legislator. Many of the legislators have an online email system, into which you can type the text of an intended letter. Others can be reached at an email address.
Two sample letters are attached- one is a more general version of the letter, the other is a bit more detailed. Please feel free to use and share with colleagues:
APA (2/9/22)
2022 Guidelines for Reporting Interactive Complexity
CMS (2/2/22)
Information for Consumers about the NSA:
Understanding Costs in Advance - Click here.
No Surprises: Understand Your Rights Against Surprise Medical Bills - Click here.
NC Health Information Exchange Authority (NCHIEA) (2/2/22)
The NCHIEA introduces a new business and provider relations manager. Also, the NC HIEA will be reaching out to unconnected providers in February. Read more here.
APA and the NSA (1/28/22)
The APA, in conjunction with ten other national organizations, has written a letter regarding the impact of the Interim Final Rules of the No Surprises Act on mental and behavioral health providers. The letter has been sent to both Xavier Becerra, Secretary of U.S. Department of Health & Human Services, and Chiquita Brooks-LaSure, Administrator, Centers for Medicare and Medicaid Services.
Click here to read the full letter here.
BCBS (1/26/2022)
State Health Plan Member ID Change for 2022
Click here to read more.
Medicare Advantage Quality Incentive Program (MAQIP)
Policy has been updated effective January 1, 2022:
Click here to read more.
HEDIS Record Reviews
BCBSNC will begin collecting our members’ medical records for the annual Healthcare Effectiveness Data and Information Set (HEDIS®1) reporting requirements. HEDIS is required by The Centers for Medicare & Medicaid Services (CMS) for all Medicare Advantage organizations. It is used for the National Committee for Quality Assurance (NCQA) accreditation and quality initiatives. BCBSNC is offering a brief overview of the annual HEDIS Medical Record Review and a review of the process for sending medical records via Blue E.
See the webinar link and read more here.
CMS (1/26/2022)
“No Surprise Billing” Overview of Rules and Fact Sheets – updated January 3, 2022
CMS (1/19/2022)
New/Modifications to the Place of Service (POS) Codes for Telehealth
Effective Date: January 1, 2022
Implementation Date: April 4, 2022
POS 02: Telehealth Provided Other than in Patient’s Home
Descriptor: The location where health services and health-related services are provided
or received, through telecommunication technology. Patient is not located in their home
when receiving health services or health-related services through telecommunication
technology.
POS 10: Telehealth Provided in Patient’s Home
Descriptor: The location where health services and health-related services are provided
or received through telecommunication technology. Patient is located in their home
(which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.
Click here to read the full announcement.
Place of Service Code Set- Updated September 2021
Click here to view.
The Trust- Updated FAQs: No Surprises Act (1/14/2022)
What is the No Surprises Act (NSA)?
The NSA was signed into law in December 2020 and was primarily intended to protect patients/clients from unexpected out-of-network bills for healthcare. The classic example is the person who obtains needed surgery at an in-network hospital but gets a separate and unexpected (surprise) $25,000 bill from the anesthesiologist after the procedure because the provider was not in-network.
Click here to read more.
Understanding the No Surprises Act (1/14/2022)
from the American Psychological Association
Psychologists and other health care providers are now required by law to give uninsured and self-pay patients a good faith estimate of costs for services that they offer. Read APA’s updated guidance and resources on when and how to provide these estimates.
Click here to read more.
Seven Basic Steps For Starting Your Good Faith Estimate Compliance (1/14/2022)
from the American Psychological Association
Here are some basic steps you need to take to start complying with the No Surprises Act good faith estimate (GFE) requirement.
Click here to read more.
APA- FAQs On No Surprises Act and Good Faith Estimates (1/14/2022)
These FAQs are based on some of the most common questions APA has received concerning the No Surprises Act and its new requirement for providers to furnish a “good faith estimate” of expected costs to patients. This requirement takes effect January 1, 2022.
Click here to read more.
CMS (1/12/2022)
The 2022 full fee schedule has been updated on the CMS website. This includes search capability for your particular Medicare Administrative Contractor (MAC), by single or multiple HCPCS codes, and other variables.
No Surprises Act (NSA) (1/7/2022)
The Trust's Preliminary Guidance on the No Surprises Act, dated 1/4/22
APA's FAQs On the NSA and Good Faith Estimates (1/7/2022)
Click here to read the document.
2022 Medicare Fee Schedule: Frequently Asked Questions (1/5/2022)
from the American Psychological Association
Each year, the Centers for Medicare and Medicaid Services (CMS) drafts proposals for new regulations or modifications to existing regulations regarding, among other things: payments, services, and billing for the following year. These proposals are made public during a comment period, after which CMS reviews feedback and issues a final ruling on the proposals. This final ruling may impact providers and patients in sometimes profound ways.
These frequently asked questions cover the changes to CMS regulations for 2022 that are most likely to impact psychologists and their patients.
Click here to read more.
Telehealth After the Pandemic: CMS Outlines Proposed Changes (1/5/2022)
Psychologists who treat and assess patients via telehealth, including audio-only devices, should pay close attention to the 2022 Medicare physician fee schedule proposed rule, which outlines potential changes to health care services and reimbursement rates for all providers. If similar proposals are adopted by other third-party payers, all psychologists—not only those who work with Medicare—will be impacted.
Click here to read more.
Telehealth Services: Billing Changes Coming in 2022 (1/5/2022)
Medicare will require psychologists to use a new point of service code when filing claims for providing telehealth services to patients in their own homes.
Click here to read more.
