The Centers for Medicare and Medicaid Services (CMS) has expanded Medicare coverage for telehealth services in response to the COVID-19 public health emergency.
Telehealth allows patients to access medical care remotely without visiting a doctor’s office or health care facility.
CMS issued numerous telehealth waivers this month. These waivers were authorized by the Coronavirus Preparedness and Response Supplemental Appropriations Act as an emergency measure until the health crisis is resolved. Prior to the waivers, Medicare restricted telehealth coverage to rural areas with limited access to medical professionals, and did not allow patients to access telehealth services from home.
Now patients living in any part of the country can access any qualified providers, which include doctors, nurse practitioners, clinical psychologists and other medical professionals. Patients can access these professionals remotely with smart phones, laptops or other electronic devices that have real-time audio/video capabilities. These real-time interactions with patients at home will not be subject to HIPAA enforcement.
The CMS waivers are temporary to protect vulnerable patients from the COVID-19 virus, and to safely treat quarantined patients at home. However, Medicare’s reimbursement for telehealth is not limited to these patients, and is open to all patients as a way to lessen the burden on the health care system. Here is a list of covered, available telehealth services.
Practitioners can bill Medicare immediately for telehealth services with dates of service starting March 6. The waivers eliminate the requirement that the originating site must be a physician’s office or health care facility, provided that the practitioner’s claim properly designates “telehealth" as the “Place of Service.” Telehealth services will be paid at the same rates as in-person services.
Commercial insurers are expected to follow Medicare’s lead in reimbursing practitioners for telehealth, although many already have embraced telehealth services in a big way. Many states also are expanding telehealth in their Medicaid programs and many, including Pennsylvania, are waiving licensing restrictions on telehealth services that cross state lines.
Although the telehealth waivers are temporary, the value of telehealth has been elevated by the COVID-19 crisis. It is anticipated that a number of the waivers will remain in place permanently, and that broad acceptance and use of telehealth is here to stay.
If anyone has any questions about telehealth or the Medicare waivers, please contact me or any member of the Barley Snyder Health Care Industry Group.
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