Improving Access to Telemental Health Services
Blueprint of Public Policy Priorities for the 119th Congress, 2025-2026
Priority:
- Expand and make permanent certain telehealth flexibilities
Legislation:
- The Telemental Health Care Access Act
Goal:
- Improve access to mental health services by eliminating the 6-month
in-person requirement for telemental health care and reimbursing all
Medicare telehealth services at the same rate as in-person services
Background:
During the COVID-19 Public Health Emergency (PHE), Medicare telehealth flexibilities were critical in enabling beneficiaries to maintain access to health and mental health care services. The American Relief Act, 2025 extended several telehealth flexibilities implemented during the PHE through March 31, 2025. One of these flexibilities enables Medicare beneficiaries to seek mental health services via telehealth without requiring an in-person visit with the treating clinician within six months of accessing mental health services. Without Congressional action, the in-person visit requirement will resume on October 1, 2025, creating an undue burden for Medicare beneficiaries. Nearly 4 in 10 beneficiaries have an income below 200% of the federal poverty level; 30% live alone; about one-fifth live in a rural area; and more than 12% are people with disabilities who are younger than 65 years old2 and would have a hard time meeting the in-person requirement. Restoring the in-person requirement would also exacerbate disparities in Medicare payment for mental health services, as the in-person requirement is unique to telemental health services. In addition, with the COVID-19 flexibilities, Medicare has reimbursed telehealth services offered by various types of providers at the same rate as equivalent in-person services. This payment parity will also no longer be mandated after September 30, 2025, creating additional barriers to health care.
In addition, before the COVID-19 pandemic, only about ten states had laws ensuring payment parity for telehealth services. The pandemic prompted many states to implement temporary measures to equalize such payments, and as of January 2025, 22 states have established permanent payment parity for services provided in person and via telehealth and 7 states have implemented parity under certain circumstances,3 demonstrating broad-based support for pay parity.
Recommendations:
Given the importance of pay parity, NASW urges policymakers to:
- Make permanent COVID-19 PHE telehealth flexibilities that removed the six-month in-person visit for telemental health care and that maintain Medicare payment parity for equivalent services delivered via telehealth and in person