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CMS Expands List of Telehealth Services Eligible for Reimbursement


Medicare and Medicaid will now cover many more services provided via telehealth, particularly by audio-only telephone.

The Centers for Medicare and Medicaid Services (CMS) has for the second time in 2 months expanded the range of telehealth services it will reimburse during the COVID-19 pandemic.

According to a CMS news release, reimbursement will be extended to additional audio-only phone services, now to include behavioral health and patient education services, among others. Payment for those services will be increased to match similar office or outpatient services, with payments retroactive to March 1.

Following are highlights of key changes.

CMS is waiving limitations on the types of clinical practitioners that can furnish Medicare-reimbursed telehealth services. Previously limited to physicians, nurse practitioners, physician assistants, and certain other HCPs, now included are physical therapists, occupational therapists, and speech language pathologists.

Federally qualified health clinics and rural health clinics will now be reimbursed for providing telehealth services.

Payment is now allowed for “partial hospitalization services,” ie, individual and group psychotherapy and patient education that are delivered in temporary expansion locations, including patients’ homes.

CMS will pay hospitals and practitioners to assess beneficiaries and collect laboratory samples for COVID-19 testing, and make separate payment when that is the only service the patient receives.

Pharmacists can now perform certain COVID-19 tests and specimen collections so long as they are enrolled in Medicare as a laboratory, the release says.

CMS will cover certain antibody tests including laboratory processing of certain FDA-authorized tests that beneficiaries self-collect at home.

Nurse practitioners, clinical nurse specialists, and physician assistants can now provide home health services to beneficiaries. These include: ordering home health services; establishing/reviewing home care plans; and certifying/recertifying that a patient is eligible for such services.

Finally, but not least, the agency is speeding up the process by which it adds new services to the list of telehealth services reimbursable under Medicare.

The full release is available here.


For more COVID-19 coverage for primary care, visit our COVID-19 Resource Page.

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