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Telehealth can be applied for substance use disorders

June 25, 2015

It makes good sense to connect people with substance use disorders (SUDs) to services. Traditional models of care are limited by the schedules of counselors who are not available outside of treatment settings, where they are needed the most, or when patients are making daily decisions about sobriety.

Telehealth can help alleviate the pressures involved in delivering care for chronic addiction by allowing for clients to access service in their preferred ways, times and locations.

In May, Addiction Science & Clinical Practice published, “Trends in telemedicine use in addiction treatment. ” The study looked at telehealth adoption among purchasers of addiction treatment services in five states and one county. The project assessed their perceptions on: telephone-based care; web-based screening; web-based treatment; videoconferencing; smartphone mobile applications (apps); and virtual worlds.

Results showed that purchasers of addiction treatment expressed the most interest in implementing videoconferencing and smartphone mobile devices. Consistent with other researchers, authors cited costs, lack of reimbursement, providers’ unfamiliarity with technology, lack of implementation models, and confidentiality regulations to be the most notable barriers.

Indeed, many barriers still exist, but from the perspective of someone working in this area for 21 years, we’ve come a long way. While my perspective may be little consolation to the consumer or counselor who can’t understand why they can’t legally communicate with each other via their computer or mobile device, their day is coming, and soon.

Reimbursement specifics

Let me give you some specifics related to telehealth reimbursement for SUDs.

First, a wide range of studies have reported that costs for telehealth interventions can often be mitigated. These studies are not always visible in the behavioral literature because they are most often published in medical and economic literature. Nonetheless, they have been documented.

While reimbursement is spotty because of differences between the states in reimbursement requirements, more than 50 percent of states now require some form of telehealth reimbursement on par with in-person care. State-by-state reimbursement advancements can be accessed through regular, free reports from the American Telemedicine Association and the Center for Connected Health Policy.

More specific to the addiction community, the Centers for Medicare and Medicaid Services (CMS) has approved a range of CPT codes for alcohol and drug interventions, including Screening, Brief Intervention, and Referral to Treatment (SBIRT) services to prevent problematic use, abuse and dependence on alcohol and illicit drugs. Smoking cessation counseling via telehealth has also been given specific CPT codes.

Also covered for telehealth reimbursement are individual therapy, group, family psychotherapy and a range of other services.

Behavioral telehealth is considered by many to be the “next big thing.” Now is the time to get informed.

Addict Sci Clin Pract. 2015 May 28;10:14. doi: 10.1186/s13722-015-0035-4.
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