An update to the NASW New Medicare Reimbursement for 2024 is available in the Tips and Tools for Social Workers.
Mirean Coleman, director of clinical practice at NASW, said the updates include:
- Medicare will reimburse 2024 claims for telehealth services using Place of Service (POS) code 10 (services provided in the patient’s home) at the non-facility rate. A non-facility rate may be reimbursed at a higher rate than a facility because it includes practice expense. The facility rate does not. Before 2024, a non-facility telehealth service at home was paid the same as a facility (in-person) rate. Since reimbursement rates vary per state, check with your Medicare Administrator Contractor (MAC) for the amount of rate change.
- Reimbursement claims for telehealth services using POS 02 (location other than the patient’s home) will be paid at the facility rate.
- It is not unusual for a MAC to be delayed in implementing new regulations. Many upgrade their electronic systems and educate staff at the beginning of the year. Please inform NASW if your MAC continues to use the 2023 fee schedule at clinical.practice@socialworkers.org
- This reimbursement change may also be adopted by other third-party payers. For information, clinical social workers should verify with each of the behavioral health insurance company with whom they are credentialed.
NASW advocated in its response to the 2024 Proposed Physician Fee Schedule to reimburse in-person telehealth services at the same rate as a facility. The association will continue its advocacy work in this area.