{"id":31911,"date":"2021-02-02T16:40:18","date_gmt":"2021-02-02T16:40:18","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=31911"},"modified":"2021-02-02T16:40:18","modified_gmt":"2021-02-02T16:40:18","slug":"cms-finalizes-telehealth-coverage-and-reimbursement-changes-in-medicare-physician-fee-schedule-rule","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-finalizes-telehealth-coverage-and-reimbursement-changes-in-medicare-physician-fee-schedule-rule\/","title":{"rendered":"CMS Finalizes Telehealth Coverage and Reimbursement Changes in Medicare Physician Fee Schedule Rule"},"content":{"rendered":"\n\n\n

The Big Picture<\/h4>\n\n\n\n

Since the onset of the COVID-19 pandemic, Congress and the Centers for Medicare & Medicaid Services (CMS) have dramatically\u2014but temporarily\u2014expanded coverage and reimbursement for telehealth services.<\/p>\n\n\n\n

On December 1, CMS issued the final calendar year (CY) 2021 Medicare physician fee schedule (MPFS) final rule<\/a> and interim final rule, including several changes to Medicare Part B telehealth payment policy. The rule makes coverage of certain services permanent, extends coverage for certain other services through the end of the calendar year in which the public health emergency (PHE) ends, and clarifies which services CMS will not be adding to the Medicare telehealth covered services list on either a permanent or temporary basis. The rule also finalizes some changes to coverage of remote physiologic monitoring services and finalizes extending the temporary flexibilities around virtual supervision through the end of 2021.<\/p>\n\n\n\n

Despite these changes, the rule also illustrates the limitations that CMS has in broadly expanding coverage and reimbursement given statutory restrictions. Without further congressional action, statutory restrictions on geographic sites, originating sites, eligible technologies, eligible providers, and federally qualified health centers (FQHCs) will come back into effect at the end of the COVID-19 PHE. And with these limitations will come decreased telehealth utilization. Based on the telehealth experience gained during the pandemic, Congress may seek to make permanent\u2014or at least extend on a longer-term basis\u2014certain of these flexibilities.<\/p>\n\n\n\n

Telehealth Flexibilities Adopted During the Pandemic <\/h4>\n\n\n\n

Most of the changes implemented during the pandemic are in effect only for the duration of the Department of Health and Human Services (HHS) PHE. As there are significant statutory restrictions on how telehealth services can be delivered and paid for in Medicare, to enact these flexibilities, the Administration relied on Section 1135 waiver authority<\/a>, which allows HHS to waive or modify certain Medicare requirements during a federally declared emergency (among other flexibilities).<\/p>\n\n\n\n

Principal changes include:<\/p>\n\n\n\n