CMS Expands Telehealth Benefits for Medicare Beneficiaries

CMS Expands Telehealth Benefits for Medicare Beneficiaries

​On March 17, 2020, the Trump administration announced expanded Medicare telehealth coverage allowing Medicare beneficiaries greater access to health care services in the safety of their homes as a “temporary resource.” This announcement follows the recent enactment of the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, an $8.3 billion dollar spending bill that lifted Medicare restrictions on telehealth coverage. Prior to these changes, Medicare was only permitted to reimburse qualified health care practitioners for certain telehealth services, such as providing routine visits to beneficiaries living in rural areas.

Effective March 6, 2020 and for the duration of the COVID-19 emergency, a wider range of health care providers will be able to offer telehealth services including physicians, nurse practitioners, clinical psychologists, and licensed clinical social workers. Medicare beneficiaries will be able to receive telehealth services in their homes or in a health care facility, including a physician’s office, hospital, nursing home or rural health clinic.

Providers can bill Medicare immediately for dates of service retroactive to March 6, 2020. Telehealth services will be paid under the Physician Fee Schedule at the same rate as in-person services. While Medicare coinsurance and deductible amounts will generally still apply, the Department of Health and Human Services Office of the Inspector General is providing some flexibility for health care providers to reduce or waive cost-sharing amounts for telehealth visits, particularly in cases of the Medicare beneficiary’s financial hardship.

In its comment, CMS stated that it anticipates this policy change will help Medicare beneficiaries access health care services without having to travel to a health care provider’s office, thereby reducing the beneficiary’s risk of exposure to COVID-19. The expansion of telehealth services may also reduce patient demand at hospital emergency departments, allowing those providers to handle more urgent cases and reduce the risk of further spreading the COVID-19 virus.

CMS provides further guidance in the Frequently Asked Questions on this announcement.

The health care industry has seen an increase in telehealth services in recent years. The COVID-19 crisis and the need for social isolation presents a unique opportunity to expand telehealth services that may prompt changes to federal and state laws. Saul Ewing Arnstein & Lehr’s lawyers regularly assist health care providers in adopting and complying with telehealth technologies in their practices. For questions about how this guidance affects your practice or company, please reach out to the authors of this article.

View Document(s):