{"id":29069,"date":"2020-09-14T19:23:31","date_gmt":"2020-09-14T19:23:31","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=29069"},"modified":"2020-09-14T19:23:31","modified_gmt":"2020-09-14T19:23:31","slug":"cms-proposes-telehealth-updates-to-the-2021-medicare-physician-fee-schedule-2","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-proposes-telehealth-updates-to-the-2021-medicare-physician-fee-schedule-2\/","title":{"rendered":"CMS Proposes Telehealth Updates to the 2021 Medicare Physician Fee Schedule"},"content":{"rendered":"\n

On August 3, the Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule<\/a> (MPFS) updates for the 2021 calendar year, addressing among other policy changes how CMS will treat telehealth codes for the duration of and following the COVID-19 public health emergency (PHE).<\/p>\n\n\n\n

Background: CMS\u2019 Process for Reviewing New Telehealth Codes<\/strong><\/p>\n\n\n\n

CMS permits any interested party to submit a request to add services to the list of codes covered by Medicare when furnished via remote practice. CMS reviews these requests to determine whether the telehealth service will be added in a subsequent MPFS rulemaking, and in doing so assigns each requested service to one of two categories. Services that are viewed as similar to existing approved telehealth codes (such as professional consultations and office visits) are reviewed on a \u201ccategory 1\u201d basis, while those services not similar to the current list fall into \u201ccategory 2.\u201d CMS reviews category 2 requests in light of whether the use of remote technology to deliver the service demonstrates a \u201cclinical benefit\u201d to the patient.<\/p>\n\n\n\n

In response to the PHE, CMS and other federal agencies have taken a series of actions to waive otherwise-applicable restrictions on the use of telehealth modalities to deliver, and be reimbursed for, patient care during the pandemic. On March 31, CMS issued an Interim Final Rule, expanding Medicare coverage for more than 80 new telehealth codes for the duration of the PHE. These services were added on a category 2 basis, and include emergency room, discharge and home visits, even if the beneficiary\u2019s communications system has only audio (and not video) capabilities. Subsequently, on May 1, CMS expanded the list on a sub-regulatory basis (as opposed to via rulemaking) to include still more telehealth services as recommended by the public or identified internally.<\/p>\n\n\n\n

Telehealth in the 2021 Proposed MPFS<\/strong><\/p>\n\n\n\n

CMS\u2019 proposed policy updates specific to Medicare reimbursement for telehealth are summarized below. CMS will consider stakeholder comments to the proposed rule received any time before 5:00 p.m. Eastern Time on October 5, 2020.<\/p>\n\n\n\n