CMS Expands COVID-19 Telehealth Reimbursement to Therapists, Phone Services

Federal officials are once again relaxing the rules for telehealth use during the Coronavirus pandemic, allowing physical therapists and other providers to be reimbursed through Medicare and expanding coverage for phone-based services.

In a long-awaited and much-anticipated April 30 announcement, the Centers for Medicare & Medicaid Services issued several directives aimed at allowing the healthcare industry to use connected health platforms and tools to improve access to care. The document, the second of its kind to be issued in the past two months, is in force only as long as the COVID-19 emergency is in place.

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The key changes regarding telehealth and mHealth coverage are as follows:

• CMS is waiving limitations on the types of care providers eligible for Medicare reimbursement, thus allowing physical and occupational therapists and speech language pathologists.
• Hospitals can now bill for outpatient services furnished remotely by hospital-based practitioners, including telehealth to patients at home – considered a “temporary provider-based department of the hospital.” They can now bill Medicare as the originating site for telehealth services furnished to those patients.
• CMS is expanding the list of audio-only phone services reimbursable through Medicare to include many behavioral health and patient education services, and the agency is increase reimbursements for those services to match similar office or outpatient services, retroactive to March 1.
• The agency is speeding up the process by which it adds new services to the list of telehealth services reimbursable under Medicare.
• Federally qualified health clinics and rural health clinics will now be reimbursed for providing telehealth services.
• CMS is waiving the video requirement for certain evaluation and management services, enabling providers to bill Medicare for services delivered by audio-only phones.

The changes address a number of issues that had been gaining publicity in recent weeks.

Several groups, including the American Psychological Association, Council of Accountable Physician Practices and American Medical Group Association, had called on CMS to ease the restrictions around phone-based services, saying many seniors and low-income families lack access to mHealth devices with video capabilities or broadband capabilities.

“Psychologists can now use their specialty skills to improve the health of ALL the communities we serve, including older adults, people with lower income or education, individuals with disabilities and people in rural areas,” APA CEO Arthur C. Evans Jr., PhD, said in a press release. “Yesterday, some of the most vulnerable people in our country did not have access to psychological care. Today, they do.”  

Also weighing in was the American Medical Association.

“With physicians reporting that Medicare patients are canceling needed medical appointments because of physical distancing and transportation challenges, the AMA commends CMS for allowing Medicare beneficiaries in underserved areas to access care from their homes,” the organization said. “This is a major victory for medicine that will enable physicians to care for their patients, especially their elderly patients with chronic conditions who may not have access to audio-visual technology or high-speed Internet. This change will help patients address their health challenges that existed before COVID-19.”

The changes also address a bill introduced last month in the House and recent lobbying efforts to include physical therapists and other care providers using telehealth during the pandemic.

The Emergency COVID-19 Telehealth Response Act, submitted by US Reps. Cindy Axne (D-IA), Troy Balderson (R-OH) and French Hill (R-AR), would expand Medicare and Medicaid reimbursement for physical and occupational therapists, clinical social workers, speech pathologists and audiologists. That bill followed a letter sent to Health and Human Services Secretary Alex Azar earlier in April calling for those care providers to be included in Medicare coverage.