• Group Psychotherapy (CPT code 90853)
• Domiciliary, Rest Home, or Custodial Care services, Established patients (CPT codes 99334-99335)
• Home Visits, Established Patient (CPT codes 99347- 99348)
• Cognitive Assessment and Care Planning Services (CPT code 99483)
• Visit Complexity Inherent to Certain Office/Outpatient E/Ms (HCPCS code GPC1X)
• Prolonged Services (CPT code 99XXX)
• Psychological and Neuropsychological Testing (CPT code 96121)

• Domiciliary, Rest Home, or Custodial Care services, Established patients (CPT codes 99336-99337)
• Home Visits, Established Patient (CPT codes 99349-99350)
• Emergency Department Visits, Levels 1-3 (CPT codes 99281-99283)
• Nursing facilities discharge day management (CPT codes 99315-99316)
• Psychological and Neuropsychological Testing (CPT codes 96130- 96133)

• Initial nursing facility visits, all levels (Low, Moderate, and High Complexity) (CPT 99304-99306)
• Psychological and Neuropsychological Testing (CPT codes 96136-96139)
• Therapy Services, Physical and Occupational Therapy, All levels (CPT 97161- 97168; CPT 97110, 97112, 97116, 97535, 97750, 97755, 97760, 97761, 92521- 92524, 92507)
• Initial hospital care and hospital discharge day management (CPT 99221- 99223; CPT 99238- 99239)
• Inpatient Neonatal and Pediatric Critical Care, Initial and Subsequent (CPT 99468- 99472; CPT 99475- 99476)
• Initial and Continuing Neonatal Intensive Care Services (CPT 99477- 99480)
• Critical Care Services (CPT 99291-99292)
• End-Stage Renal Disease Monthly Capitation Payment codes (CPT 90952, 90953, 90956, 90959, and 90962)
• Radiation Treatment Management Services (CPT 77427)
• Emergency Department Visits, Levels 4-5 (CPT 99284-99285)
• Domiciliary, Rest Home, or Custodial Care services, New (CPT 99324- 99328)
• Home Visits, New Patient, all levels (CPT 99341- 99345)
• Initial and Subsequent Observation and Observation Discharge Day Management (CPT 99217- 99220; CPT 99224- 99226; CPT 99234- 99236)

• Remove the Medicare geographic restrictions and allow the home to be an originating site for mental telehealth services
• Remove the geographic restrictions for certain originating sites for emergency medical care services
• Remove the geographic restrictions for federally qualified health centers (FQHCs) and rural health clinics (RHCs) and allow FQHCs and RHCs to furnish telehealth services as distant sites

• Establish a grant program for health providers in rural areas to expand telemental health services
• Direct HHS secretary to award grants for provision of telemental services in rural areas

• Amend the Public Health Service Act with respect to telehealth enhancements for emergency response
• Evaluate mechanisms for payment or reimbursement for use of telehealth technologies and personnel during public health emergencies
• Evaluate infrastructure and resource needs to ensure providers have the necessary tools, training, and technical assistance to provide telehealth services

• Simplify payments for telehealth services furnished by FQHCs and RHCs under the Medicare program
• Increase limits on payment for RHC services

• Permanently remove Medicare’s geographic restrictions for certain originating sites for emergency medical care services for mental and behavioral health services
• Continue eligibility of care for the expanded list of non-physician providers
• Allow Medicare to cover audio-only telehealth services

• Extend ability to prescribe Medication Assisted Therapies (MAT) and other necessary drugs without needing a prior in-person visit
• Extend ability to bill Medicare for audio-only telehealth services

• Remove geographic barriers for originating site
• Expand access to mental health services through telehealth in frontier states
• Direct FCC and Department of Agriculture to work with IHS and HRSA to award grants for broadband infrastructure

• Remove Medicare’s geographic restrictions for all evaluation and management (E/M) services
• Categorize mental health services as E/M services in order to expand telehealth coverage of mental health services in Medicare

• Allow (but not require) the HHS Secretary to extend the temporary telehealth flexibilities made available during the PHE until December 31, 2021 or until the end of the PHE, whichever is later
• Require the Medicare Payment Advisory Commission (MedPAC) to provide a report on the impact of telehealth flexibilities on access, quality, and cost by July 1, 2021
• Require HHS to post data on use of telehealth throughout the pandemic and provide a report including legislative recommendations to Congress to later than 15 months after the bill is enacted
• Extend for five years beyond the end of the PHE a provision of the CARES Act which permits FQHCs and RHCs to serve as distant sites for the purposes of delivery telehealth

• Remove geographic barriers for originating site
• Require telehealth services to be covered by Medicare at FQHCs and RHCs
• Direct HHS to permanently expand the telehealth services covered by Medicare during the PHE
• Require Medicare to cover additional telehealth services for hospice and home dialysis care

• Enable health care professionals licensed in good standing to care for patients—in-person or through telehealth visits—from any state during this national emergency without jeopardizing their state licensure or facing potential penalties for unauthorized practice of medicine

• Authorizes $2 billion in dedicated funding across the government for distance learning and telehealth initiatives, including:
  • $400 million for the Federal Communications Commission (FCC) COVID-19 Telehealth Program, including a 20% set aside for small, rural providers that may have been left out of the competitive first round of telehealth funding
  • 100 million for the Department of Veterans Affairs (VA) Telehealth and Connected Care Services for the provision of Internet-connected devices and services for veterans in rural, unserved areas

• Standardize telehealth reimbursement formula for RHCs and FQHCs

• Require CMS to study the effects of telehealth changes on Medicare and Medicaid during COVID-19

• Codify Medicare telehealth reimbursement for community health centers and RHCs

• Invest $50 million in rural communities to increase access to telehealth during COVID-19

• Direct the HHS Secretary and the Comptroller General of the United States to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children’s Health Insurance programs during the COVID-19 emergency

• Permit the HHS Secretary to waive requirements relating to the furnishing of telehealth services under the Medicare program

• Codify the removal of geographic restrictions waived in Medicare during the PHE

• Eliminate most geographic and originating site restrictions in Medicare and establish the patient’s home as an eligible distant site
• Authorize CMS to continue reimbursement for telehealth for 90 days beyond the end of the PHE
• Allow HHS to expand telehealth in Medicare during all future emergencies
• Require a study on the use of telehealth during COVID-19

• Require HHS to study telehealth use during the pandemic and impact on care delivery

• Packages nine telehealth bills introduced by republican lawmakers including:
  • H.R. 7338: Advancing Telehealth Beyond COVID-19
  • H.R. 5473: EASE Behavioral Health Services Act
  • S. 4039: Telemedicine Everywhere Lifting Everyone’s Healthcare Experience and Long Term Health (TELEHEALTH) HAS Act
  • H.R. 3228: VA Mission Telehealth Clarification Act
  • H.R. 4900: Telehealth Across State Lines Act
  • S. 4103: Treat Act
  • H.R. 7233: Keep Telehealth Options Act
  • S. 3988: Enhancing Preparedness Through Telehealth Act
  • H.R. 7187: HEALTH Act

H.R. 8156: Ensuring Telehealth Expansion Act of 2020

• Extend telehealth all provisions in the CARES Act through December 31, 2025
• Remove geographic barriers for originating site
• Require payment parity for telehealth services furnished at FQHCs and RHCs

• First, the act allows the CMS to extend coverage of telehealth services to beneficiaries regardless of where they are located. This means even if the beneficiary is not in a healthcare facility or located in a nonurban or physician shortage area, the beneficiary can receive a covered telehealth visit. This new provision should allow beneficiaries to access telehealth from their homes or from other community locations.
• Second, the act allows CMS to extend coverage to telehealth services provided by “telephone” but only those with “audio and video capabilities that are used for two-way, real-time interactive communication” (e.g., smartphones). However, to deliver the services, as the act is currently structured, a provider or member of the provider’s practice must have treated the patient within the past three years.

• Cover Medicare Parts A and B services and supplemental Part C plan benefits furnished at noncontracted facilities; this means that facilities that furnish covered A/B benefits must have participation agreements with Medicare.
• Waive, in full, requirements for gatekeeper referrals where applicable.
• Provide the same cost-sharing for the enrollee as if the service or benefit had been furnished at a plan-contracted facility.
• Make changes that benefit the enrollee effective immediately without the 30-day notification requirement at 42 § 422.111(d)(3). Such changes could include reductions in cost-sharing and waiving of prior authorizations.

• Section D. Opioid Treatment Programs (OTPs) – Furnishing Periodic Assessments via Communication Technology (42 CFR 410.67(b)(3) and (4)): Temporary change to allow periodic assessments of individuals treated at OTPs to occur during the PHE by two-way interactive audio-video or audio-only communication
• Section N. Payment for Audio-Only Telephone Evaluation and Management Services: Temporary increase in the reimbursement rates for telephonic care
• Section AA. Updating the Medicare Telehealth List (42 CFR 410.78(f)): Temporary change to remove Medicare regulations that require amendments to the list of covered telehealth services be made through the physician fee schedule (PFS) rulemaking process and allow changes to be made to the list of covered telehealth services through subregulatory guidance only

• Section 3704 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act authorizes RHCs and FQHCs to provide distant site telehealth services to Medicare beneficiaries. Services can be provided by any health practitioner working for the RHC or the FQHC as long as the service is within their scope; there is no restriction on locations where the provider may be to furnish telehealth services.
• FQHCs and RHCs are paid a flat fee of $92 when they serve as the distant site provider for a telehealth visit.
• CMS will pay for all reasonable costs for any service related to COVID-19 testing, including relevant telehealth services. RHCs and FQHCs must waive the collection of co-insurance for COVID-19 testing-related services.

• Virtual communication services now include online digital evaluation and management services. CPT codes 99421–23 have been added for non-face-to-face, patient-initiated, digital communications using a secure patient portal.