Even after the pandemic ends, telehealth appears poised to stay, according to APA’s 2021 COVID-19 Practitioner Survey of U.S. psychologists who are either APA members or prospective members.
A whopping 96% of psychologists who responded said that telehealth is effective therapeutically, and 97% said that it should remain post-pandemic. The number of clinicians using telehealth with at least some patients also continues to grow, from 33% in 2020 to 50% in 2021.
More clinicians practicing telehealth will lead to increased access to much-needed care. According to the survey, demand for psychological services has jumped over the past year. Forty-three percent of the psychologists surveyed reported an increase in their number of patients, and 68% reported that their waiting lists had grown since the pandemic’s beginning.
One factor helping to eliminate barriers to meeting that demand is the Psychology Interjurisdictional Compact (PSYPACT)opens in new window. Amid the pandemic’s turmoil, some college students returned home and families moved or temporarily relocated to less dense areas. Some practitioners were no longer able to provide services because their patients had moved outside their state of licensure. PSYPACT allows psychologists in participating jurisdictions to provide services across state lines, either via telepsychology or temporary in-person practice.
PSYPACT had a record-breaking year, said Janet Orwig, the program’s executive director. Twenty-two states introduced PSYPACT legislation, 12 enacted legislation, and 2 more have bills pending. In total, 27 jurisdictions have enacted PSYPACT legislation.
The Association of State and Provincial Psychology Boards (ASPPB), which runs the E.Passport program—one of the prerequisites for authorization to participate in PSYPACT—has also expanded eligibility to allow psychologists who have practiced independently since 1985 based on a doctoral degree from a regionally accredited institution to participate.
Telehealth practice beyond the pandemic
In the practitioner survey, about half of the respondents said that APA should continue to support telehealth. Advocacy is already under way to ensure that the telehealth gains made during the pandemic aren’t lost, said Connie Galietti, JD, director of legal and professional affairs in APA’s Office of Legal and State Advocacy.
“At the start of the pandemic, payers swung the telehealth doors wide open,” said Alan Nessman, JD, senior special counsel for legal and regulatory affairs at APA, citing coverage of audio-only telehealth as one example of expanded telehealth coverage. Two years later, some payers are no longer allowing telehealth for out-of-network providers or no longer waiving copays. “We expect that things will end up not completely wide open, but somewhere in between,” said Nessman.
Maintaining payment parity is another priority, said Stephen Gillaspy, PhD, director of health care financing at APA. “Before COVID, psychologists got paid less for providing telehealth services than for providing services in person,” he said. “During COVID, payers said, ‘We’re going to pay you the same amount to make sure everyone gets services.’”
APA is also pushing payers to maintain the expanded number of services eligible for telehealth in patients’ homes, said Gillaspy. Other advocacy goals include expanding audio-only telehealth beyond mental health diagnoses to include Health Behavior Assessment/Intervention CPT codes and eliminating a Centers for Medicare & Medicaid Services requirement that patients have an in-person visit with a provider within 6 months of starting telehealth services.
“APA is pushing on a variety of fronts to keep most of these telehealth gains going, but real grassroots advocacy by psychologists is so important,” added Nessman. “When you get a call to action from APA or a state psychological association, please send in comments in support of expanded telehealth.”
