Medicare’s mandatory in-person visit requirements for psychiatric care
Medicare’s recent mandatory in-person visit requirements for psychiatric care creates downstream effects that reduce patient access, retention, and change industry capital structure
CMS overview of the Medicare tele-mental health in-person requirement (and related flexibilities): https://lnkd.in/gdmDUN2K
Examples of how the new ruling will affect the mental health industry and more importantly restricts patient access:
• Reduces access for patients who rely on telehealth for privacy and discretion
• Disrupts continuity in a specialty with high monthly patient retention and long treatment durations, a significant issue in psychiatry where the therapeutic relationship is personal, trust-based, and built over time
• Shrinks the addressable patient pool, particularly rural, elderly, and mobility-limited populations
• Forces nationally scaled tele-psychiatry platforms to establish physical, in-state footprints to continue to serve patients in those states
• Converts what was a low-CAPEX, distributed care model into one requiring real estate, staffing, and fixed overhead for states where psychiatrists do not have a physical location
• Raises potential risk that commercial payors may follow Medicare’s lead, introducing similar in-person requirements and further pressuring national telehealth models
For organizations built around national virtual delivery, this isn’t a workflow tweak — it’s a structural shift in unit economics and growth strategy.
Telehealth wasn’t just convenience; for many psychiatric patients, it was the only viable access point. Like most rulings, expect that other payors will follow suit.
