The issues generated by the pandemic’s need for more telemedicine isn’t only about the effectiveness or limits of that kind of medical practice. It’s also: who pays for telemedicine?

A new bipartisan telemedicine bill introduced in Congress in December, 2020, would expand Medicare coverage for audio-only “telehealth” visits. Medicare currently will pay for video medical visits, such as those done on Zoom or similar platforms. But the bill’s proponents want Medicare to reimburse providers who provide audio-only visits for mental or behavioral care. The bill is called “The Permanency for Audio-Only Telehealth Act.”

Opponents of the bill contend that a telephone call alone is not a proper platform for establishing a provider-patient relationship, saying that “virtual visits by phone should be allowed only in limited circumstances and after an in-person exam.” 

Supporters of the proposed law argue that for rural or underserved areas limited broadband and technology access, the audio medical visits can be the only effective means of providing crucial behavioral health care. The bill received support of the American Psychological Association (APA). The CEO of the group, Dr. Arthur Evans, Jr., said that “allowing patients to receive mental health services by audio-only telephone is a matter of health equity for underserved populations.” 

The difficult circumstances of the pandemic have created crises in multiple health care sectors. Providers, insurers, and lawmakers have had to get creative in a hurry to fill in the service gaps. The question of who pays for telemedicine is tied up with the type of service being provided. We hope that this continues a trend to creatively expand services around the country.