CMS looks to permanently expand telehealth services

An elderly woman has a virtual visit with her doctor
The Centers for Medicare & Medicaid Services has moved to permanently expand telehealth services for rural areas beyond the COVID-19 pandemic, but it will need congressional approval for full-scale expansion. (Jean-philippe WALLET/Getty Images)

The Trump administration added more than 60 telehealth services that will be reimbursable during the public health emergency caused by the COVID-19 pandemic. Those changes to telehealth coverage will also be allowed permanently in rural areas.

The Centers for Medicare & Medicaid Services (CMS) added the telehealth services as part of the final Physician Fee Schedule released late Tuesday. That annual regulation governing physician payments included payment adjustments to evaluation and management visits. 

As part of the telehealth expansion, the agency said it added several services to category one, which includes services similar to office visits or psychiatry services and consultations. Services added include group psychotherapy, home visits and psychological testing.

It also added services to the Medicare telehealth list category three, including emergency department visits, therapy services and hospital discharge day management.

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CMS also created a temporary category of criteria for adding telehealth services during the public health emergency for COVID-19, but it will remain in place after that emergency period ends. The public health emergency has been in place since February and has enabled CMS to give more flexibility on what services can be reimbursed.

But a permanent expansion of coverage across the country will require an act of Congress. Only certain areas will continue to get the telehealth services after the public health emergency ends. Currently the public health emergency is set to expire in January but could be postponed. 

“These additions 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 said in a release.

Medicare Advantage beneficiaries can still get access to telehealth services after the public health emergency ends. 

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Medicare does not have the statutory authority to permanently expand the services to areas outside of rural areas, with certain exceptions.

"If they want to provide these telehealth services in those categories to Medicarebeneficiaries across the country they will need something like the Telehealth Modernization Act put in the Senate in July to lift the rural restriction," said Ryan Bailey, vice president with the consulting firm Advis.

The agency is commissioning a study on the telehealth flexibilities it has provided during the pandemic. Telehealth use has exploded as patients have been afraid to go to the doctor’s office for fear of contracting COVID-19. Since the start of the pandemic, CMS has added 144 telehealth services that it will cover.

CMS reported Tuesday that preliminary data show from mid-March to mid-October, more than 24.5 million people out of 63 million Medicare beneficiaries used a telemedicine service.