CMS Expands Medicare Telehealth Coverage With 11 New Billable Services
The Trump administration is again expanding the list of telehealth services that Medicare will cover during the public health emergency (PHE), adding 11 new virtual care services that eligible providers could get paid for.
According to an announcement last week from the Centers for Medicare & Medicaid Services (CMS), CMS is adding 11 new services to the Medicare telehealth services list since the publication of the May 1, 2020, COVID-19 Interim Final Rule with comment period. Medicare will begin paying eligible practitioners who furnish these newly added telehealth services effective immediately, and for the duration of the PHE. These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services.
In the May 1 COVID-19 IFC, CMS modified the process for adding or deleting services from the Medicare telehealth services list to allow for expedited consideration of additional telehealth services during the PHE outside of rulemaking. This update to the Medicare telehealth services list builds on the efforts CMS has already taken to increase Medicare beneficiaries’ access to telehealth services during the COVID-19 PHE, agency officials stated.
Since the beginning of the PHE, CMS has added more than 135 services to the Medicare telehealth services list – such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services. With this latest action, Medicare will pay for 144 services performed via telehealth. Between mid-March and mid-August 2020, over 12.1 million Medicare beneficiaries – over 36 percent – of people with Medicare fee-for-service have received a telemedicine service, CMS officials reported.
What’s more, in an effort to provide greater transparency on telehealth access in Medicaid and CHIP, CMS is releasing, for the first time, a preliminary Medicaid and CHIP data snapshot on telehealth utilization during the PHE. This snapshot shows, among other things, that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year, representing an increase of more than 2,600 percent when compared to the same period from the prior year. The data also shows that adults ages 19 to 64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states.
“CMS is taking action to increase telehealth adoption across the country,” said Administrator Seema Verma. “Medicaid patients should not be forgotten, and today’s announcement promotes telehealth for them as well. This revolutionary method of improving access to care is transforming healthcare delivery in America. President Trump will not let the genie go back into the bottle.”
In early August, President Trump signed an executive order to further expand access to telehealth services during the COVID-19 pandemic, especially in rural communities. Through this order, the administration also took action to extend the availability of certain telehealth services after the current public health emergency ends, via a new proposed rule. Some of those include home visits for the evaluation and management of a patient (in the case where the law allows telehealth services in the patient’s home), and certain types of visits for patients with cognitive impairments. Those specific proposals were part of numerous proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues for the 2021 calendar year.
