T he Centers for Medicare and Medicaid Services (CMS) established new changes to accelerate payments for telemedicine services. As per Trump’s order on “Improving Rural and Telehealth Access,” CMS takes extensive measures to make the temporary telemedicine services permanent after the global health crisis ends.

CMS had implemented a few changes temporarily to address the telehealth needs during the COVID-19 crisis. Some of these changes have now been made permanent as per a recent executive order.

The services include physical therapy, inpatient visits, substance abuse treatment, and mental health counseling that will be covered under the insurance. CMS proposes a permanent solution to telehealth services including home visits for evaluation and management of patients under certain circumstances—and managing patients with cognitive impairments. Along with these new announcements, the agency has also temporarily extended payment for few other telemedicine services including emergency department visits, for a specific timeframe until the global health crisis ends.

Why This Matters

Before the pandemic, telemedicine reimbursement was limited. Post the COVID-19 scenario, CMS has been constantly expanding the possibilities for telemedicine solutions—starting with Medicare Advantage plans for the remote areas.

Whilst the global pandemic has locked people home, CMS’s relaxation of telehealth policies has opened up new opportunities with skyrocketing worldwide adoption of virtual care and telehealth solutions.

Nursing Facility Visits and Other Telehealth Flexibility

When stakeholders raised a concern around how the once in 30-day frequency limitation for nursing facility visits was creating increased burdens—while limiting access to the beneficiaries, CMS is taking new initiatives to revise frequency limitations from once in 30 days to one visit every three days. Furthermore, CMS seeks stakeholders’ perspectives on if it helps to remove frequency limitations altogether and if it would improve patient access and better delivery of care.

The agency also reassures that physicians including physical therapists, occupational therapists, clinical social workers, clinical pathologists, and speech-language pathologists, can qualify for the Medicare benefits.

The agency has further been requested to clarify on if the telehealth scenario would still be applicable if the practitioner and the beneficiary are in the same location. For instance, the physician and the beneficiary are in the same setting but opt for telemedicine services to avoid risks of exposure. However, the CMS rule reiterates the fact that telemedicine rules do not apply when a physician and beneficiary are using telehealth platforms from the same location—despite using virtual care solutions.

In the recently released COVID-19 interim rule, CMS stated separate payment for audio-only telemedicine services. While this proposed solution may not be applicable post the pandemic scenario, these interactions are currently being covered under the Medicare benefits. However, the agency seeks viewpoints from stakeholders on whether this should be a provisional policy or expanded beyond the pandemic times.

CMS has further proposed payment for new remote physiologic monitoring services. In the 2021 Physician Fee Schedule proposed rule, CMS is also relaxing rules to further facilitate direct supervision, through audio and video channels until 31st December 2021.

CMS seeks stakeholder viewpoints on whether there should be any restrictions, or it should consider expanding the time limit for this specific policy. The due date for public comments on the proposed rules is the 5th of October.

The Bigger Picture

Over the past few years, CMS has taken several initiatives to modernize Medicare via telemedicine solutions, and private sector innovations to reimagine rural health strategic measures. At the beginning of 2019, Medicare proposed payments for virtual check-ins, where patients across the nation could slickly connect with their physicians to check if they require to come in for an in-person visit. To combat the health risks of COVID-19, the agency expanded payment for telemedicine services and proposed other flexibilitie

Before the COVID-19 emergency, approximately 14,000 beneficiaries received virtual care services in a week. This has drastically increased to over a staggering 10.1 million beneficiaries who have utilized telemedicine services from the mid of March to early July.

This highlights the significance of telemedicine solutions during the pandemic crisis, which could stretch far beyond these emergency times. With this sudden spike in demand for virtual care, hospitals and practices are increasingly adopting telehealth solutions—to thrive during these uncertain times. Consider that over half of primary visits are now being performed through telehealth platforms.

Presenting JoinDr. Telehealth Software

There has been a seismic shift in the adoption of Telehealth Solutions- in the wake of the COVID-19 pandemic. To support this change, SolvEdge takes the initiative to provide temporary licenses of our secure cloud-based telehealth platform, JoinDr. at No Cost to healthcare organizations. SolvEdge’s patient engagement solution is a successful platform used by over 450 hospitals, 3500+ physicians and millions of patients worldwide.

To learn more about the JoinDr. Telemedicine Platform, reach out to us at +1-(833) 33-Solve / business@solvedge.com - or simply talk to our team.