#PNN_TelehealthReimbursement

The Centers for Medicare and Medicaid Services (CMS) announced a broad package of waivers and other changes including 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.

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.  

According to the announcement:

  • CMS is expanding the list of audio-only phone services reimbursable through Medicare to include many behavioral health and patient education services, and the agency is increasing reimbursements for those services to match similar office or outpatient services, retroactive to March 1.
  • Hospitals can now bill for outpatient services furnished remotely by hospital-based practitioners, including telehealth to patients at home – considered a “temporary provider-based department of the hospital.” They can now bill Medicare as the originating site for telehealth services furnished to those patients.
  • The agency is speeding up the process by which it adds new services to the list of telehealth services reimbursable under Medicare.
  • Federally qualified health clinics and rural health clinics will now be reimbursed for providing telehealth services.
  • CMS is waiving the video requirement for certain evaluation and management services, enabling providers to bill Medicare for services delivered by audio-only phones.

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