Telehealth has been used more widely to treat Medicare recipients during COVID-19, due to a number of recent public health and emergency declarations and new legislative authority granted to HHS. While this new authority is time-limited, the expanded use of telehealth during COVID-19 will provide a natural experiment for how to expand telehealth in the Medicare Program going forward. Although many providers are making initial investments to increase their telehealth capacity, it is important to note that permanent expansion will require CMS’s careful analysis of data culled from telehealth usage during the public health emergency.
This issue brief provides an overview of all recent changes to telehealth policies enabled by the following:
- CMS COVID-19 Telehealth Expansion Waiver (enacted by CMS on March 17) extends Medicare payments for office, hospital, and other visits furnished via telehealth across the country, starting March 6, 2020 and extending through the duration of the public health emergency. The waiver lifts the requirement that the patient reside in a designated rural area and receive services at a local clinic, hospital, or certain other types of medical facility. Reimbursement rates for providers are the same as regular, in-person visits.
- The CARES Act (signed into law on March 27) expands the use of telehealth in Medicare by allowing services to be paid with no deductible, waiving the requirement that the provider has treated the patient in person during the last three years, permitting remote monitoring of home health patients, and more.
- Interim final rule with comment (IFC), Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (released March 30), effectively implemented many of the changes authorized by the CARES act, and allowed for more than 80 additional services, reimbursement of certain audio-only E/M telephone codes to new and established patients, the ability to provide remote patient monitoring of patients with acute and chronic conditions, and more.
- Interim final rule with comment period, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program (enacted April 30), permits hospitals to bill for remote services furnished to Medicare patients registered as hospital outpatients, broadens the list of reimbursable audio-only services to include many behavioral health and patient education services, and more.