by Wyn Staheli, Director of Research
May 4th, 2020
On April 30, 2020, CMS announced additional sweeping changes to meet the challenges of providing adequate healthcare during this pandemic. These changes expand the March 31st changes (see this article). The article covers some of the key changes. See the official announcement in the references below.
Medicare Telehealth Eligible Providers
The waiver now “expands the types of health care professionals that can furnish distant site telehealth services to include all those that are eligible to bill Medicare for their professional services.” If you are eligible to bill Medicare, you may be reimbursed for telehealth visits.
Expanded Audio Only Services
Audio only services were previously covered for patients and their doctors, but this expansion now allows for more services to be provided via audio only (e.g., behavioral health and patient education services). It also significantly increases the amount they will pay for these services retroactively to March 1, 2020. This will further help ease the burden of patients who do not have access to or are unfamiliar with video technology.
Alert: Please note that this is regular Medicare only and might not apply to Medicare Advantage (Part C) plans. For example, a May 1, 2020 announcement by Regence stated that for Medicare Advantage, telehealth services must be both audio and video. Be sure to verify individual payer requirements for Part C claims prior to providing these services.
Changed the Addition of Services Process
The addition of telehealth services has previously only been done through the rulemaking process. Now, additional services can be made whenever CMS feels there is a need, and they will even consider suggestions from providers regarding which services to allow via telehealth.
Added More Locations
The previous limitations on locations for services was also expanded.
- Rural Health Clinics (RHCs) and Federally Qualified Health Clinics (FQHCs) were previously not allowed to bill for telehealth services. This expansion allows healthcare services to reach even more beneficiaries - particularly those in areas where there are few providers and travel may be difficult.
- Hospitals, including Critical Access Hospitals (CAHs), now have telemedicine provisions (42 CFR §482.12(a) (8)–(9) for hospitals and §485.616(c) for CAHs) waived “making it easier for telemedicine services to be furnished to the hospital’s patients through an agreement with an off-site hospital. This allows for increased access to necessary care for hospital and CAH patients, including access to specialty care.“