Medicare Physician Fee Schedule Expands Telehealth Coverage

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The 2021 Physician Fee Schedule (PFS) final rule recently released by the Centers for Medicare & Medicaid Services (CMS) includes the addition of 60 new telehealth services that will be covered and reimbursed by Medicare. The new services will allow Medicare beneficiaries to have greater access to telehealth, with a particular focus on residents of rural areas, even after the COVID-19 public health emergency ends. CMS had previously added coverage for 144 new telehealth services through the end of the emergency period.

The final rule implementing the PFS creates a new temporary “Category 3” list that includes, for example, home visits for established patients, emergency department visits levels one through five, critical care services, and hospital and nursing facility discharge day management services. Category 3 services will remain on the Medicare telehealth services list through the end of the calendar year in which the public health emergency ends. CMS will continue to evaluate whether more services should be added to the coverage list in the future and which services should be made permanent.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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