April 30, 2020
Area(s) of Interest: Payor Issues and Reimbursement
The Centers for Medicare and Medicaid Services (CMS) announced on Thursday a significant expansion of telehealth services so physicians and other providers can deliver a wider range of care to Medicare patients in their homes. Most notably, CMS will now be increasing payments for telephone visits to match payments for similar office and outpatient visits. This change is retroactive to March 1, 2020.
The California Medical Association and the American Medical Association have been pushing for this change, which is a major victory that will enable physicians to care for their patients—especially their elderly patients with chronic conditions— who may not be able to navigate or do not have access to audio-visual technology or high-speed internet. The rule change was part of a broad package of waivers and other changes intended to expand access to telehealth and facilitate COVID-19 testing.
According to the CMS, when a clinician provides an E/M service using audio-only technology, they should bill using the telephone services E/M code (99441-99443), provided that the required elements in the applicable code description are met.
Using new waiver authority, CMS is also allowing many behavioral health and education services to be furnished via telehealth using audio-only communications. Click here for the full list of telehealth services, including which services are eligible to be furnished via audio-only technology.