The Centers for Medicare & Medicaid Services (CMS) recently put forth a proposed rule that would extend certain telehealth waivers through 2025. Among them:
- Federally qualified health centers and rural health clinics would continue to be able to bill for non-behavioral health telehealth services.
- Providers would continue to be allowed to report enrolled practice addresses instead of home addresses when delivering services from their home.
- Prior to 2020, there were limitations on the number of telehealth consultations that inpatient, nursing facility, and critical care patients could receive for subsequent care services. The waiver eliminating those limits would continue.
- The definition of what is meant by “direct supervision” would continue to acknowledge that a virtual presence by way of audio/video real-time communications technology is just as efficient as in-person supervision. Along the same lines, virtual supervision of residents when the service is performed virtually across teaching settings – both Metropolitan Service Areas and Non-Metropolitan Service Areas – would remain in effect.
CMS’s proposed rule also would change the definition of what constitutes an interactive telecommunications system, broadening the definition to include two-way, real-time audio-only communication when delivering telehealth to a patient’s home where the patient does not have or does not consent to video technology.
While there are strides included that would make permanent some telehealth flexibilities, there is concern regarding an element that would update physician fee schedule payments, reducing calendar year 2025 payments from CMS’s 2024 levels.
The American Hospital Association (AHA) shared in a recent announcement that a reduction in payments could pose a threat to patient access and provider financial stability, especially for safety-net providers.
CMS is also proposing to conduct a wide-ranging analysis of all provisional codes on the Medicare Telehealth Services List with the goal of making a comprehensive determination as to their status down the road.
The AHA urged CMS to collaborate with Congress to permanently remove restrictions on telehealth services and expand telehealth eligibility to more providers. If no action is taken, many of these important waivers will expire at the end of 2024.
The complete proposed rule from CMS can be found here along with their commentary on each item. CMS will accept comments until 5:00 PM EST on September 9, 2024.