When COVID-19 reached the United States, our first priority at Providence was to limit exposure to both patients and providers. Due to CMS waivers related to the COVID public health emergency, we were able to treat patients irrespective of geography or location using 5 telehealth solutions.
COVID-19 increased our telehealth offerings and opened the door for wide scale use of virtual visits, enabling us to continue care for our communities. Because of the pandemic, CMS temporarily added 135 codes to the list of covered telehealth services, making it easier to use telehealth as a substitute for in-person visits.
Unfortunately, with CMS’s new changes to Medicare, our ability to continue telehealth services in 2021 will be limited. CMS is proposing that only 9 of the 120+ temporary telehealth codes be added permanently to the 2021 Physician Fee Schedule, which will include the following services.
- Visit Complexity Associated with Certain Office/Outpatient E/M’s
- Prolonged Services
- Group Psychotherapy
- Neurobehavioral Status Exam
- Care Planning for Patients with Cognitive Impairment
- Domiciliary, Rest Home, or Custodial Care Services
- Home Visits
These codes do increase access for patients and providers who need them. However, it’s important to remember that these codes have specific use cases, making it difficult for broader adoption of telehealth services.
For example, our health system experienced a huge demand for mental health care during COVID-19. We were able to provide TelePsychiatry services to our patients, including those who live outside of rural HPSA locations. Post COVID-19, CMS’s regulations will go back into effect and non-rural/HPSA telehealth services will no longer be covered by Medicare and payers following Medicare payment policies.
While this is a significant change for CMS compared to previous years, it means that 126 codes added as part of the COVID waivers will no longer be covered, limiting our ability to be reimbursed for telehealth services rendered to patients in our communities once the public health emergency is over.
Health systems need to act now and respond to the new CMS proposal by gathering data and sharing patient stories of how telehealth services have benefited them, not just during COVID-19. We have a long way to go before we can provide more telehealth services and be reimbursed for them on a broader scale.
Expanding access to telehealth is critical so that we can continue providing affordable and accessible care to all.
Contact: Lisa Roche, Manager of Telehealth Billing and Coding, to learn more.