CMS Announces Permanent Expansion of Medicare Telehealth Services
On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) announced in an MLN Special Edition the release of its annual Physician Fee Schedule final rule (Final Rule). As part of the Final Rule, effective January 1, 2021, CMS is adding more than 60 services to the Medicare telehealth list that will continue to be covered beyond the end of the COVID-19 Public Health Emergency (PHE). The telehealth services currently being adopted will allow beneficiaries in rural areas who are in a medical facility (like a nursing home) to continue to have access to telehealth services such as certain types of emergency department visits, therapy services, and critical care services. CMS stated its adoption of a proven alternative like telehealth was pursuant to President Trump’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors, further stating:
“During the COVID-19 pandemic, actions by the Trump Administration have unleashed an explosion in telehealth innovation, and we’re now moving to make many of these changes permanent,” said HHS Secretary Alex Azar. “Medicare beneficiaries will now be able to receive dozens of new services via telehealth, and we’ll keep exploring ways to deliver Americans access to health care in the setting that they and their doctor decide makes sense for them.”
Before the COVID-19 PHE, CMS data indicated that only 15,000 Fee-for-Service beneficiaries each week received a Medicare telemedicine service. After adding 144 telehealth services during the PHE, preliminary data indicates that, between mid-March and mid-October 2020, over 24.5 million out of 63 million beneficiaries and enrollees received a Medicare telemedicine service during the PHE. Although only 66 of the 144 PHE telehealth services are being added at the start of 2021, CMS stated that it “will continue to gather more data and evaluate whether more services should be added in the future.” Importantly, as CMS noted, it currently does not have the statutory authority to pay for telehealth to beneficiaries outside of rural areas or, with certain exceptions, to allow beneficiaries to receive telehealth in their homes.
For ease of reference, we have prepared a chart summarizing some of the more significant telehealth services to be adopted beyond the PHE: Click here.