Evan Dumas 

You’re listening to Group Practice Tech, a podcast by Person Centered Tech, where we help mental health group practice owners ethically and effectively leverage tech to improve their practices. I’m your co-host, Evan Dumas.

 

Liath Dalton 

And I’m Liath Dalton, and we are Person Centered Tech.

 

Liath Dalton 

This episode is brought to you by Therapy Notes. Therapy Notes is a robust online practice management and electronic health record system to support you in growing your thriving practice. Therapy Notes is a complete practice management system with all the functionality you need to manage client records, meet with clients remotely, create rich documentation, schedule appointments and bill insurance all right at your fingertips. To get two free months of Therapy Notes as a new Therapy Notes user go to therapynotes.com and use promo code PCT.

 

Evan Dumas 

Hello and welcome to Episode 540: Medicare Telehealth Update.

 

Liath Dalton 

Hello, everybody, and welcome to this episode of Practice Tech. I am so pleased to be joined by my wonderful friend and colleague, the marvelous Gabrielle Juliano-Villani of Medicare Consulting for Therapists, and many more things. But today that bonafide is the one that’s the most impactful.

 

Liath Dalton 

Gabrielle, it has been exactly one month to the date at the time of recording since we were talking about all of the Medicare telehealth changes, when the flexibility is extended, and there have been some developments since then.

 

Gabrielle Juliano-Villani 

There have been, I knew there would be, it just took a little bit of time considering everything that was happening and going on, but we have, I think it’s good news. I hope everybody else thinks it’s good news too. But really, this has been pushed back yet again. What what has been pushed back, you might be wondering, I didn’t clarify. The in-person visit requirement for telehealth for Medicare is pushed back to January 31 of 2026.

 

Liath Dalton 

Exactly. So the like big thing that was the takeaway when we previously discussed all of this was that it wasn’t going to really be impactful for established clients, meaning anyone who a provider had seen either in-person or via telehealth through September 30, 2025, right?

 

Gabrielle Juliano-Villani 

Yep.

 

Liath Dalton 

Because then for established clients, the in person annual assessment requirement is exactly that, annual.

 

Gabrielle Juliano-Villani 

Yeah.

 

Liath Dalton 

And so we had a nice long sort of runway, as it were, to figure out how to navigate that. And we figured that, in all likelihood, despite the, how should I put it, disarray, ineptitude, current efficacy, or lack thereof, of our Congress, that there was good likelihood that there would be an extension in place before that one year, so like October 1 2026 hit for established clients.

 

Gabrielle Juliano-Villani 

Mhm.

 

Liath Dalton 

What was impacted in this little interim period was taking on new clients, right? So those who a provider hadn’t seen.

 

Gabrielle Juliano-Villani 

Yup.

 

Liath Dalton 

So I should actually turn it, turn it over to you properly, to describe like all of that. And also, I think we have to get in a little hey, we told you. It’s okay. It’s okay to take a breath and a beat. We know this is all really activating and understandably so and and causing anxiety and distress. And when it comes to established clients, there is time to put a plan in place and be able to navigate things. And I mean, I. I see a lot of signs of hope in the extension happening and how quickly it happened, so I’ll turn it over to you to say the nitty gritty of it.

 

Gabrielle Juliano-Villani 

I also feel hopeful about it because I mean, it happened right away, as soon as the government reopened, like I felt like one of the first things,

 

Liath Dalton 

Yeah.

 

Gabrielle Juliano-Villani 

that got pushed through. So that is good news, and that is hopeful. And really, I just, I think, you know, this happens every time, is that it gets to the last minute and they have all of these things that they need to do that are on their plate, just like everybody else, just like every other job, and they

 

Liath Dalton 

Right.

 

Gabrielle Juliano-Villani 

run out of time or whatever. And so it does feel stressful, because it often happens at the 11th hour.

 

Liath Dalton 

And this one was like the 13th hour.

 

Gabrielle Juliano-Villani 

The 13th hour for sure. And everybody was freaking out, which I understand. Because if you have a telehealth only practice, if you are a compact clinician, if you are licensed in multiple states, like it is scary and it is stressful to try and figure out, like, what am I going to do here for my practice? What does this mean?

 

Gabrielle Juliano-Villani 

But one thing that I want to say, and this is kind of off topic, but also related, because this just goes with being a business owner, is that there’s always these ups and downs. And I can tell you, from owning a practice to getting so deep beyond burnout from shit like this happening all the time, and like, really spending the last four, almost five years like working through all of that, going out on the other side and building another business, like it is so hugely important to have some sort of coping skills when things like this come up, and to just understand that this is part of the process.

 

Gabrielle Juliano-Villani 

And I’m not trying to minimize anybody’s stress or anxiety around these things, but this is part of it. There’s ups and there’s downs, and if you get yourself all worked up every single time, it’s going to be very dysregulating to your nervous system, your clients and your business. That way, it always gets figured out. There’s always some sort of pivot.

 

Gabrielle Juliano-Villani 

And I even think of, I think I might have said this on our webinar too, but when I had my practice that was, you know, it was started before covid, and then during covid, we had to figure out telehealth, and Medicare didn’t really cover telehealth before covid, and so it was like, What am I supposed to do? And I just did what I thought was the best in that moment, and it ended up being fine, and it all got figured out. And now we have telehealth for Medicare.

 

Liath Dalton 

Right.

 

Gabrielle Juliano-Villani 

So there’s options, and there’s always choices. And just know, like, especially when you’re dealing with the government, there’s a lot of red tape, and it just takes a little bit of time. And here we are, you know, after the fact, it’s gotten pushed back again, I think it will get pushed back again. I hope that eventually, it will be made permanent. But there’s nothing I think, right now, to freak out about. You can enjoy the holidays and the end of the year.

 

Liath Dalton 

Yes, exactly.

 

Gabrielle Juliano-Villani 

You can wait out the year.

 

Liath Dalton 

And those are big parts of why I appreciate your perspective and how you approach things, is that sort of rooted in reality, and what is the impact on on your nervous system and you as a clinician, a human, a business owner, and trying to center how we navigate all of those pieces simultaneously, right?

 

Liath Dalton 

So, what are the the main takeaways in terms of practical application or like impact that we have from the recent extension that occurred last week, like almost immediately, as soon as the government shutdown ended.

 

Gabrielle Juliano-Villani 

So you don’t need to do an initial in-person visit before telehealth. I think that’s probably the biggest.

 

Liath Dalton 

Mhm.

 

Gabrielle Juliano-Villani 

So if you are getting new Medicare clients, you can see them telehealth. It’s totally fine, everything is good. I think that’s the biggest thing is you don’t need to do that initial in-person visit. And the annual in-person visit, that clock doesn’t start now till January 31, unless it gets pushed back again.

 

Gabrielle Juliano-Villani 

So, you don’t need to see, basically, you don’t need to see anybody in person, unless you want to. But you can all of your Medicare clients telehealth, and everything will be fine. Um, so you don’t have to worry about that right now.

 

Gabrielle Juliano-Villani 

I know, I saw some people had already seen their clients in person. So yay, you got to see them in-person, you figured it out. Otherwise, you know, there’s nothing that you need to do differently right now. Keep seeing your clients telehealth. You know, if you’re listening to this, you’re probably on both of our email lists, but if you’re not, then you should definitely opt in to both Person Centered Tech and my email newsletter, because these are the types of things that we keep you updated on, and we will let you know if there is any other changes that are upcoming.

 

Liath Dalton 

Exactly. So key points: You can now, until January 30, at least, take on new clients, new Medicare clients, and see them in a telehealth only capacity. You do not have to do an in person visit prior to seeing them. That’s for new clients.

 

Liath Dalton 

So I know there’s been this, like month and a half gap, basically, for folks where, in terms of, technically speaking, taking on new clients, the in-person visit requirement was applicable. But really that is the one and only materially significant thing that was impacting folks right?

 

Gabrielle Juliano-Villani 

Mhm, yep.

 

Liath Dalton 

Otherwise, the in-person visit requirement for established clients, that that clock was, initially, only going to, kind of, run out at the end of September, next year, in 2026. Now that’s been kicked, basically, from what’s just happened, in terms of the extension, until at minimum January 30, 2027 right?

 

Liath Dalton 

So there, there is more time, and we have a good indicator that despite the shambles that everything is in, that there, that there is, you know, there’s political will behind making this something that is considered to be of high importance, and that action is going to be taken around. So that’s really good, that should be reassuring. I mean, there are so many other considerations and priorities that we would I think, speaking for myself and Gabrielle as humans would love them to also be taking action on, which maybe haven’t transpired, but the fact that they are taking action on this is really good, like at least there’s that that’s something to hold on to.

 

Gabrielle Juliano-Villani 

I love that, and I agree. It is a little glimmer, a little anchor that we can hold onto. It feels good. I was really happy to see that. And I do also want to say, like, if you were somebody who did write your legislators, that does work. So if you think that it doesn’t, this is showing you that it does.

 

Liath Dalton 

Yeah, exactly. Use, use your voice and let them know how important that is, so that when things come up again, ahead of the January 30 expiration, that they know how important it is to take action and make this extension yet again.

 

Gabrielle Juliano-Villani 

We also had spoken about, in our webinar, which I’ll say again here as well, if you’re getting, you know, if nothing changes, let’s say, and we’re getting close to that, like in person, yearly, annual requirement, I, you know, Liath and I talked about this, that we kind of felt like, if it’s 90 days out and nothing has changed, then maybe start making a plan. But as of right now, I mean, you have that entire year. So I don’t, I wouldn’t worry about rushing and getting stressed about trying to find a place to see your clients. I, you know, that’s a future problem, right?

 

Liath Dalton 

Exactly, it’s a future problem. And really, I think the only thing to potentially consider is if you have, if you’re wanting to onboard new clients and your thinking, well if things take some time to get extended again, and there is a gap between the current new flexibilities expiration date of the end of January 2026, what do I do if I’m trying to onboard a new client? That’s the only potential area to to address, is figuring out how, if they don’t extend again. But that, in the scheme of things, is is much smaller of a hurdle to clear, than trying to figure out the in-person for, for all clients. But like we said, you you now have, at minimum, until the end of January, 2027.

 

Gabrielle Juliano-Villani 

Yep. Lots and lots of time.

 

Liath Dalton 

Lots and lots of time. And Gabrielle’s guidance, of like, if we’re getting, like, three months out from when that actually kicks in and nothing has been extended, then start making a plan. But between now and then, don’t don’t worry about that. Focus on client care and self care and business care. And that’s not something that needs to be draining your capacity and bandwidth.

 

Gabrielle Juliano-Villani 

Exactly. And, there was something else I was gonna say about that. I don’t know.

 

Liath Dalton 

It’s all good. So I just want to thank you, Gabrielle, once again, for for being like the anchor, the calm in the center of the storm of all of this, and the understandable distress that it creates among practice owners, and let folks know that they can connect with you. I mean, you offer so many wonderful things, but if they’re specifically focused on the Medicare piece, they can connect with you through Medicare Consulting for Therapists. You have an awesome free newsletter and a Facebook group, and so I highly recommend, if you’re not already on that and you’re have listened this far, it means that Medicare must be applicable to your practice, so definitely get connected with that ongoing resource, and we’ll keep you apprised as always, of any impactful developments.

 

Liath Dalton 

But otherwise, just take moment, take a beat, take care of yourselves and your practices, and we’ll chat to you good folks next week.

 

Gabrielle Juliano-Villani 

Thank you.

 

Liath Dalton 

This has been Group Practice Tech. You can find us at personcenteredtech.com. For more podcast episodes, you can go to personcenteredtech.com/podcast or click podcast on the menu bar.