decisionhealth Newsletters, Part B News - 2019 Issue 4 (April)
Get ready for a sea of telehealth services under Medicare Advantage in 2020
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Article Overview
This piece covers CMS’s 2020 final rule on Medicare Advantage telehealth flexibility and the practical implications for providers, billing teams, and practice administrators. It outlines how MA plans may expand telehealth offerings, how coverage is determined at the plan level, why network participation and patient communication matter, and how cost-sharing differences may affect front-office workflow. The article is relevant to organizations serving Medicare Advantage populations and to readers tracking payer-specific telehealth policy changes.
Why This Topic Matters
The rule changes how Medicare Advantage plans may structure telehealth benefits, so providers may need to review plan-by-plan coverage, billing expectations, and patient cost-sharing processes. Understanding the policy helps practices prepare for payer variation and operational impacts in 2020 and beyond.
Article Sections
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Medicare Advantage telehealth changes for 2020
Introduces CMS’s updated Medicare Advantage policy environment and the broader expansion of telehealth options under the 2020 rulemaking.
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Determining covered services
Discusses how MA plans may identify eligible telehealth offerings and how coverage decisions are expected to vary by plan.
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Plans have the power
Covers plan-level authority, provider network considerations, and the need for stakeholders to monitor approved benefit offerings.
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Mind cost-sharing variations
Reviews the topic of patient cost-sharing differences for telehealth services and the related administrative considerations for practices.
What You Will Learn
- How CMS framed Medicare Advantage telehealth flexibility for 2020
- How MA plans may differ in the services they choose to include
- Why provider networks and plan communication matter for telehealth access
- What practices should watch regarding patient cost-sharing for electronic services
- Why telehealth coverage may require payer-specific operational planning
Who Should Read This
- Medical coders
- Billing specialists
- Practice administrators
- Revenue cycle staff
- Physicians and other clinicians serving Medicare Advantage patients
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