CMS Outlines Telehealth Reimbursement for 2020-21 eCQM Programs

The Centers for Medicare & Medicaid Services has released additional details on telehealth reimbursement through quality reporting programs for the 2020 and 2021 performance periods.

The eligible Clinical Quality Measures (eCQMs) are used by care providers participating in programs such as Advanced Alternative Payment Models (Advanced APMs), the Merit-Based Incentive Payment System (MIPS), APM programs Comprehensive Primary Care Plus (CPC+) and Primary Care First (PCF), and the Medicaid Promoting Interoperability Program.

The list for the 2020 performance period features 42 telehealth-eligible eCQMS, while the list for the 2021 performance period features 39 telehealth-eligible eCQMS.

The list features Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) encounter codes that are available for either in-person of virtual visits based on the list of services reimbursed under the Medicare Physician Fee Schedule.

The notices also point out that there may be times when a telehealth encounter isn’t enough to “complete the quality action.” In those instances, the care provider must make sure he or she can meet all other aspects of the quality action within that specification, including quality actions that need to be completed outside of telehealth.