CMS Expands Medicare Telehealth Coverage

In an effort to limit the spread of the COVID-19 (coronavirus) outbreak, the Centers for Medicare & Medicaid Services (CMS) on March 17 announced the expansion of Medicare coverage for telehealth nationwide, effective immediately. CMS will temporarily pay clinicians to provide telehealth services for Medicare beneficiaries residing anywhere in the U.S. so that those who are managing chronic illness or health issues can stay home without compromising their access to healthcare. CMS also released a Fact Sheet and FAQs that provide guidance to both Medicare beneficiaries and providers on what the expanded telehealth coverage includes.

Before the expansion, Medicare paid for telehealth only on a limited basis, if the Medicare beneficiary lived in a designated rural area and received the service at a hospital, clinic or approved medical facility. Now, Medicare beneficiaries will be able to receive specific services at home that previously had to be provided in person, including evaluation and management visits, mental health counseling, and preventive health screenings. A wide range of providers, including hospitals, physicians, nurse practitioners, licensed social workers and clinical psychologists, may now offer telehealth services. Although standard Medicare copays and deductibles will still apply for telehealth visits, providers will have the flexibility to waive or reduce patients’ cost-sharing burdens.

Three modes of telehealth services are covered under the expansion: full telehealth visits, brief “virtual check-ins,” and e-visits through a provider’s online patient portal. To the extent that a telehealth service normally requires a pre-existing physician-patient relationship, during the current public health emergency the U.S. Department of Health and Human Services (HHS) will refrain from conducting audits to ensure that such an established relationship existed. In addition, HHS announced that it will not impose penalties against providers that provide telehealth services to patients through everyday communications technologies, such as FaceTime or Skype.