Telehealth

Medicare

Since early March 2020, the Centers for Medicare and Medicaid Services (CMS) have issued guidance expanding the use of telehealth during the COVID-19 public health emergency.Under the guidance provided to date, licensed clinical social workers who are enrolled in Medicare can be reimbursed for telehealth services provided:

• To new or established Medicare beneficiary clients
• To clients whether the client is in their own home or in any healthcare setting
• From their own home (in addition to their office or another location)
• Using communication technology allowing real-time, two-way interactive communication, beyond those allowed pre-COVID. This includes smartphones with video chat technologies such as Apple FaceTime and Skype, as well as video conferencing that was permissible pre-COVID.
• Using audio-only devices (e.g. landlines) for certain services (including psychotherapy, opioid treatment and certain Telephone Evaluation and Management Services).

Note that Internet-facing smartphone apps such as TikTok or Facebook Live, or chat rooms such as Slack, are still prohibited because they allow wide public access to the communication.

Telehealth services are reimbursed at the same rate as in-person services. Claims can be back dated to March 6. Providers may reduce or waive cost-sharing for telehealth visits during this emergency period (except for E-Visits).

The U.S. Department of Health and Human Services (HHS) will exercise enforcement discretion and waive penalties for most HIPAA violations against providers who serve patients in good faith through everyday communication technologies during this public emergency.

Visit Telehealth and Medicare During COVID-19 to learn more.

The telehealth waiver will be effective until the public health emergency declared by the Secretary of Health and Human Services ends.

Access NASW's webinar "Key Developments in Medicare Telehealth Options During COVID-19"

For more details about telehealth flexibilities:

• President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak
• Medicare Telehealth Frequently Asked Questions (CMS)
• Medicare Telemedicine Health Care Provider Fact Sheet
• Medicare Provider Enrollment, Chain, and Ownership System (PECOS)
• Online Medicare Practitioner Enrollment Form
• Checklist for Medicare Practitioner Enrollment
• CMS Video on Medicare Coverage and Payment of Virtual Services - This video provides answers to common questions about the Medicare telehealth services benefit.
• Medicare Revises Telehealth Place of Service and Modifier Codes During COVID-19 - NASW Practice Alert
• COVID-19 Pandemic: Implications for Social Workers Treating Individuals with Substance Use Disorders- NASW Practice Alert

Legal and Practice Resources for Social Workers 

• Telemental Health: Legal Considerations for Social Workers
• 8 Ethical Considerations for Starting a Telehealth Practice
• Telemental Health Informed Consent form
• Telemental Health Informed Consent form (Spanish)
• Standards for Technology in Social Work Practice
• Medicare Revises Telehealth Place of Service and Modifier Codes During COVID-19 - NASW Practice Alert
• Tips for Successfully Implementing Teletherapy - Social Work Talks podcast
• Social Workers' Disclosure Responsibilities During the Pandemic
• COVID-19: Legal Considerations for Social Workers Resuming In-Person Services
• Informed Consent for In-Person Services
• Informed Consent for In-Person Services (Spanish)

Interstate Teletherapy

NASW is also advocating to ensure that licensed CSWs can provide teletherapy to individuals, such as college students, who may have moved out of state temporarily due to the pandemic. Numerous states have implemented temporary flexibilities in regulation that will enable licensed CSWs can provide services across state lines. We are collaborating with the Association of Social Work Boards (ASWB) in providing information to clinical social workers about temporary licensure and waivers during states of emergency. Please see the section below for more information about waivers and other policy actions.

Association of Social Work Boards (ASWB)

The Association of Social Work Boards (ASWB) is the membership association for state social work licensing authorities. ASWB monitors state legislative and regulatory actions that impact the regulation of the social work profession. ASWB also maintains a database of information on state social work licensing requirements. ASWB has compiled resources to help social workers understand regulations impacting social work teletherapy as well as license exemptions and temporary license requirements applicable during a declared state of emergency.

For more information, access ASWB regulatory reports at aswb.org. To access requirements for regulated licenses, see Detailed Reports: Compare license information.

For more information regarding social work teletherapy, temporary license provisions and license exemptions use Detailed Reports: Compare Jurisdiction Information. Select the state(s) of interest, and the report sections “Statutory Provisions” and “License Exemption Language.”

Access a report to generate direct links to the statutes and regulations impacting social work in a particular state, or to contact a licensing authority directly.

See ASWB's Regulatory provisions for social work emergency responders and COVID-19 policy actions for a table showing state-by-state COVID-19 related licensing and telehealth actions.

Professional Liability Coverage

Your NASW RRG professional liability policy provides coverage for teletherapy as long as it is an accepted practice conducted according to the individual practitioner's state regulations, state licensing board requirements, and HIPAA privacy standards which vary by state and are continually evolving. Find out more at naswassurance.org.