As Telehealth Use Skyrockets CMS Expands Payment List

A blue door with two small holes in it.

The Centers for Medicare & Medicaid Services (CMS) recently announced that more than 34.5 million services were delivered via telehealth to patients in Medicare and the Children’s Health Insurance Program (CHIP) from March through June. That equates to an approximately 2,632 percent jump compared to the same period in 2019. However, CMS noted that since claims tend to lag, that figure is expected to increase. CMS noted that preliminary data suggests that services delivered via telehealth were highest among working age adults, followed by children and older adults.

The pandemic, combined with the roll-back of federal regulatory barriers, are driving the popularity of virtual visits.

Earlier this month, CMS announced that for the first time, using a new expedited process, it added 11 new services to the Medicare telehealth services list since the publication of the May 1, 2020, COVID-19 Interim Final Rule. The expedited process allows CMS to expand its list of those services reimbursable under Medicare without following usual rule-making procedures. The added 11 services brings to 144, the number of services on Medicare’s telehealth services list.

The new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services. The full list can be found here.

CMS indicated it would begin paying for the services immediately and throughout the duration of the public health crisis.

At the same time, CMS released an updated State Medicaid and CHIP Telehealth Toolkit.

In it, CMS acknowledges that while telehealth has been a useful tool during the pandemic, many states are considering implementing policies for continued telehealth flexibilities even after the public health crisis is over.

“States may use this supplemental toolkit to help think through how they will explain and clarify which policies are temporary or permanent, when flexibilities will expire, which services can be accessed through telehealth, which providers may deliver those services, the modality they may use to deliver telehealth services, and the circumstances under which telehealth can be reimbursed,†CMS noted.

Whether providers will continue to offer telehealth may depend on reimbursement rates. A recently released joint KLAS Research and Center for Connected Medicine survey of 117 health system execs found that just 20 percent of U.S. healthcare systems would continue offering telehealth if reimbursement rates went back to pre-pandemic levels, while another 30 percent indicated they were not certain whether they would continue to offer virtual care.

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The Health Law Offices of Anthony C. Vitale