On March 17, 2020, President Trump announced temporarily expanded Medicare telehealth coverage to enable Medicare patients to receive a wider range of health care services from their doctors via telehealth. Effective for dates of services beginning March 6, 2020, and continuing throughout the public health emergency declared by the Secretary of Health and Human Services (HHS) on January 31, 2020, the Centers for Medicare & Medicaid Services (CMS) will pay clinicians to provide telehealth services to Medicare beneficiaries across the country.
President Trump previously announced an emergency declaration, which allowed CMS to expand Medicare telehealth benefits under Section 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act (Act). Before this announcement, Medicare paid for telehealth services only if the Medicare patient lived in a rural area and traveled to a local medical facility to receive telehealth services from a doctor located in a remote location. It did not permit Medicare patients to receive telehealth services in their homes.
This change will permit beneficiaries to receive certain services, including office visits, mental health counseling and preventive health screenings without needing to go to a doctor’s office or a health care facility. Medicare patients will now be able to access their doctors using a wide range of technology, including telephones with audio and video capabilities, such as smartphones, and will be able to receive telehealth services in all settings, including their homes. This change will allow beneficiaries to follow CDC guidance on social distancing to reduce the risk of COVID-19 transmission. Importantly, CMS will not be enforcing a prior relationship requirement included in the Act, which will allow broader access to telehealth services during this public health emergency. CMS also issued Medicare Telehealth Frequently Asked Questions, which outlines the expanded Medicare telehealth benefits more specifically.
Telehealth services are paid under the Medicare Physician Fee Schedule at the same rate as in-person services. In addition, the HHS Office of Inspector General is providing flexibility to reduce or waive patient cost-sharing for telehealth visits paid for by the federal government and furnished during the public health emergency declared by HHS beginning January 31, 2020. State Medicaid programs already pay for some telehealth services, such as telephone and video technology available on smartphones and similar devices, without federal approval. However, any Medicaid changes in telehealth payment will be up to each state’s Medicaid program.
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