CMS Covers Telehealth During Emergency Declaration

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Under an emergency declaration, the Centers for Medicare & Medicaid Services (CMS) recently announced that telehealth benefits for Medicare beneficiaries have been expanded beyond the virtual check-ins and e-visits that were allowed under the program in 2019. The expansion, considered temporary, was granted by waivers under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

On April 9, 2020, the CMS released a comprehensive Frequently Asked Questions update in which 22 questions specifically targeted telehealth coverage under the Medicare fee-for-service guidelines. Topics included section 1135 of the CARES Act’s Public Health Emergency waivers and the difference between telehealth visits and virtual check-ins, as well as criteria for Medicare reimbursement for telehealth services.

In their updated guidance, the CMS considers Medicare telehealth visits the same as in-person visits, with the same reimbursement; however, it requires 2-way real-time interactive communication between providers and patients using both audio and video technology. As a result, a range of providers, including physicians, nurse practitioners, clinical psychologists, and licensed clinical social workers, are now able to offer telehealth to their patients.

Telehealth services can be provided using specific phones, and HIPAA privacy laws regulating providers who seek to deliver care remotely are relaxed during the public health emergency declaration. “The Office of Civil Rights has also issued guidance allowing covered healthcare providers to use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk of penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency,” the CMS cited.

The telehealth waiver will be effective until the end of the Public Health Emergency declared by the Secretary of Health and Human Services (HHS) in response to the COVID-19 pandemic. The HHS Office of Inspector General is also providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.

In addition to telehealth visits, Remote Physiologic Monitoring services can be furnished to new and established patients for the duration of the Public Health Emergency. In doing so, the CMS suspended the requirement that there be an established relationship between the healthcare provider and the patient.

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Last modified: June 8, 2020