Medicare Telehealth Frequently Asked Questions
Medicare issued a waiver for telehealth services for the public health
emergency. But which services are allowed, and who are permitted to furnish
them? Keep reading to find answers to these and many more questions!
Question: What services can be offered via telehealth in the period of waiver for the public health
emergency (PHE) declared by the Secretary under the section 1135 waiver authority?
Answer: Telehealth services allowed by Medicare include many of the services that are normally furnished in person. The CMS has a list of services that may be furnished via Medicare telehealth, which is available here: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
Question: Which health care practitioners are permitted to provide telehealth services under the broadened 1135 waiver authority granted by the CARES Act?
Answer: With the waiver, any health care practitioner who is authorized to bill Medicare for their professional services can provide and bill for telehealth services. Meaning, health care professionals who were not previously authorized under the statute to furnish and bill for Medicare telehealth services, such as physical therapists, occupational therapists, speech-language pathologists, and others, can receive payment for Medicare telehealth services. Also, telehealth services performed by auxiliary personnel, such as respiratory therapists, who cannot independently bill Medicare for their services can be furnished and billed incident to the services of an eligible billing practitioner.
Question: Does a health care provider need any specialized equipment to furnish Medicare telehealth services?
Answer: At the moment, CMS requires most telehealth services to be furnished using
Telecommunication technology with audio and video capabilities that are used for two-way, real-time interactive communication. So, any mobile computing device that has audio and video capabilities, which can be used for two-way, real-time interactive communication, may be used to furnish Medicare telehealth services.
On March 1, 2020, CMS issued a waiver, allowing telephone evaluation and management codes and certain counseling behavioral health care and educational services to be furnished as telehealth services using audio-only communications technology (telephones or other audio-only devices). There is a list of those services here: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
For all other Medicare telehealth services, there should be audio, and video equipment permitting two-way, real-time interactive communication between the patient and a distant-site physician or practitioner.
Question: What is the amount Medicare pays for telehealth services?
Answer: The amount Medicare pays for telehealth services is the same it pays if the service were furnished in person.
Question: How long will the waiver last?
Answer: The telehealth waiver will remain effective for as long as the PHE declared by the Secretary of HHS on January 31, 2020, lasts. So, billing for the expanded Medicare telehealth services, telephone assessment and management, telephone evaluation and management services, and additional flexibilities for communications technology-based services (CTBS) are effective beginning March 1, 2020, and through the end of the PHE.
Question: Should physicians and practitioners let their patients know that Medicare covers
telehealth in new locations during the PHE?
Answer: Yes, physicians and practitioners should let their patients that services are available via telehealth in new locations, including their homes, during the PHE, and they should also educate them on any applicable cost-sharing.
Question: Should on-site visits conducted via video or through a window in the clinic suite be reported as telehealth services, and how would a physician or practitioner bill if this were telehealth?
Answer: The only services that should be reported as telehealth services are those where the physician or practitioner furnishing the service is not at the same location as the beneficiary. In other words, when the physician or practitioner furnishes a service from a place other than where the beneficiary is located (a “distant site”), they should report those services as telehealth services. However, if the beneficiary and the physician or practitioner furnishing the service are in the same institutional setting but are utilizing telecommunications technology to furnish the service due to exposure risks, the practitioner would not need to report this service as telehealth and should instead report whatever code used for the in-person service furnished.
Question: Does the distant-site practitioner need to be in a medical facility to furnish Medicare telehealth, or can they furnish the services from their home?
Answer: There are no payment restrictions on where distant site practitioners can furnish Medicare
telehealth services from, so they can do that from home during the public health emergency.
Question: What about situations where the beneficiaries do not have access to smartphones or other technology that supports two-way, audio, and video telecommunications technology or when the patient does not want to use video?
Answer: Effective from March 1, 2020, until the end of the PHE, health care providers can bill certain Medicare telehealth services furnished via audio-only calls, including telephone evaluation and management services, and specific behavioral health care and educational services. The providers can bill for these services for both new and established patients.