{"id":31706,"date":"2020-12-01T19:49:00","date_gmt":"2020-12-01T19:49:00","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=31706"},"modified":"2020-12-01T19:49:00","modified_gmt":"2020-12-01T19:49:00","slug":"cms-finalizes-permanent-expansion-of-medicare-telehealth-services-and-improved-payment-for-time-doctors-spend-with-patients","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-finalizes-permanent-expansion-of-medicare-telehealth-services-and-improved-payment-for-time-doctors-spend-with-patients\/","title":{"rendered":"CMS Finalizes Permanent Expansion of Medicare Telehealth Services and Improved Payment for Time Doctors Spend with Patients"},"content":{"rendered":"\n\n\n

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CMS-Finalizes-Permanent-Expansion-of-Medicare-Telehealth-Services-and-Improved-Payment-for-Time-Doctors-Spend-with-Patients<\/a>Download<\/a><\/div>\n\n\n\n

Today the Centers for Medicare & Medicaid Services (CMS) released the annual Physician Fee Schedule (PFS) final rule, prioritizing CMS\u2019 investment in primary care and chronic disease management by increasing payments to physicians and other practitioners for the additional time they spend with patients, especially those with chronic conditions. The rule allows non-physician practitioners to provide the care they were trained and licensed to give, cutting red tape so healthcare professionals can practice at the top of their license and spend more time with patients instead of on unnecessary paperwork. This final rule takes steps to further implement President Trump\u2019s Executive Order on Protecting and Improving Medicare for Our Nation\u2019s Seniors including prioritizing the expansion of proven alternatives like telehealth.<\/p>\n\n\n\n

\u201cDuring the COVID-19 pandemic, actions by the Trump Administration have unleashed an explosion in telehealth innovation, and we\u2019re now moving to make many of these changes permanent,\u201d said HHS Secretary Alex Azar. \u201cMedicare beneficiaries will now be able to receive dozens of new services via telehealth, and we\u2019ll keep exploring ways to deliver Americans access to healthcare in the setting that they and their doctor decide makes sense for them.\u201d<\/p>\n\n\n\n

\u201cTelehealth has long been a priority for the Trump Administration, which is why we started paying for short virtual visits in rural areas long before the pandemic struck,\u201d said CMS Administrator Seema Verma. \u201cBut the pandemic accentuated just how transformative it could be, and several months in, it\u2019s clear that the healthcare system has adapted seamlessly to a historic telehealth expansion that inaugurates a new era in healthcare delivery.\u201d<\/p>\n\n\n\n

Finalizing Telehealth Expansion and Improving Rural Health <\/strong><\/p>\n\n\n\n

Before the COVID-19 public health emergency (PHE), only 15,000 fee-for-service beneficiaries each week received a Medicare telemedicine service. Since the beginning of the PHE, CMS has added 144 telehealth services such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, that are covered by Medicare through the end of the PHE. These services were added to allow for safe access to important health care services during the PHE. As a result, preliminary data show that between mid-March and mid-October 2020, over 24.5 million out of 63 million beneficiaries and enrollees have received a Medicare telemedicine service during the PHE.<\/p>\n\n\n\n

This final rule delivers on the President\u2019s recent Executive Order on Improving Rural Health and Telehealth Access by adding more than 60 services to the Medicare telehealth list that will continue to be covered beyond the end of the PHE, and we will continue to gather more data and evaluate whether more services should be added in the future. 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. Medicare does not have the statutory authority to pay for telehealth to beneficiaries outside of rural areas or, with certain exceptions, allow beneficiaries to receive telehealth in their home. However, this is an important step, and as a result, Medicare beneficiaries in rural areas will have more convenient access to healthcare.<\/p>\n\n\n\n

Additionally, CMS is announcing a commissioned study of its telehealth flexibilities provided during the COVID-19 PHE. The study will explore new opportunities for services where telehealth and virtual care supervision, and remote monitoring can be used to more efficiently bring care to patients and to enhance program integrity, whether they are being treated in the hospital or at home.<\/p>\n\n\n\n

Payment for Office\/Outpatient Evaluation and Management (E\/M) and Comparable Visits<\/strong><\/p>\n\n\n\n

Last year, CMS finalized a historic increase in payment rates for office\/outpatient face-to-face evaluation and management (E\/M) visits that goes into effect in 2021. The Medicare population is increasing, with over 10,000 beneficiaries joining the program every day. Along with this growth in enrollment is increasing complexity of beneficiary healthcare needs, with more than two-thirds of Medicare beneficiaries having two or more chronic conditions. Increasing the payment rate of E\/M office visits recognizes this demand and ensures clinicians are paid appropriately for the time they spend on coordinating care for patients, especially those with chronic conditions. These payment increases, informed by recommendations from the American Medical Association (AMA), support clinicians who provide crucial care for patients with dementia or manage transitions between the hospital, nursing facilities, and home. <\/p>\n\n\n\n

Under today\u2019s final rule, CMS continues to prioritize this investment in primary care and chronic disease management by similarly increasing the value of many services that are similar to E\/M office visits such as maternity care bundles, emergency department visits, end-stage renal disease capitated payment bundles, and physical and occupational therapy evaluation services. These adjustments ensure CMS is appropriately recognizing the kind of care where clinicians need to spend more face-to-face time with patients.<\/p>\n\n\n\n

\u201cThis finalized policy marks the most significant updates to E\/M codes in 30 years, reducing burden on doctors imposed by the coding system and rewarding time spent evaluating and managing their patients\u2019 care,\u201d Administrator Verma added. \u201cIn the past, the system has rewarded interventions and procedures over time spent with patients \u2013 time taken preventing disease and managing chronic illnesses.\u201d<\/p>\n\n\n\n

In addition to the increase in payment for E\/M office visits, simplified coding and documentation changes for Medicare billing for these visits will go into effect beginning January 1, 2021. The changes modernize documentation and coding guidelines developed in the 1990s, and come after extensive stakeholder collaboration with the AMA and others. These changes will significantly reduce the burden of documentation for all clinicians, giving them greater discretion to choose the visit level based on either guidelines for medical decision-making (the process by which a clinician formulates a course of treatment based on a patient\u2019s information, i.e., through performing a physical exam, reviewing history, conducting tests, etc.) or time dedicated with patients. These changes are expected to save clinicians 2.3 million hours per year in administrative burden so that clinicians can spend more time with their patients.<\/p>\n\n\n\n

Professional Scope of Practice and Supervision <\/strong><\/p>\n\n\n\n

As part of the Patients Over Paperwork Initiative, the Trump Administration is cutting red tape so that healthcare professionals can practice at the top of their license and spend more time with patients instead of on unnecessary paperwork. The PFS final rule makes permanent several workforce flexibilities provided during the COVID-19 PHE that allow non-physician practitioners to provide the care they were trained and licensed to give, without imposing additional restrictions by the Medicare program.<\/p>\n\n\n\n

Specifically, CMS is finalizing the following changes:<\/p>\n\n\n\n