Medicare beneficiaries will have access to a wider range of health services during the COVID-19 Public Health Emergency as the result of expanded telehealth coverage. The Trump Administration and the Centers for Medicare & Medicaid Services (CMS) implemented the changes as part of the emergency declaration to ensure ongoing healthcare while limiting exposure through social distancing.
In a recent CMS press release Administrator Seema Verma shared, “The Trump Administration is taking swift and bold action to give patients greater access to care through telehealth during the COVID-19 outbreak. These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus. Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.”
The telehealth service expansion began March 6, 2020, and will continue through the COVID-19 Public Health Emergency. Reimbursement for telehealth services will be provided for designated providers in any health care facility or in the home setting.
Further details are available by reviewing the following CMS resources.
- Medicare Telehealth Frequently Asked Questions
- Medicare Telemedicine Health Care Provider Fact Sheet
Fact Sheet Key Takeaways:
- Effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances.
- These visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.
- Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings.
- While they must generally travel to or be located in certain types of originating sites such as a physician’s office, skilled nursing facility or hospital for the visit, effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any healthcare facility and in their home.
- The Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
- To the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.
Additional COVID-19 Updates and Resources for Healthcare Professionals can be found on the Great Plains Quality Innovation website.