T e le he a lth Upda te s June 2020 CMS K a nsa s City Offic e - PowerPoint PPT Presentation

T e le he a lth Upda te s June 2020 CMS K a nsa s City Offic e

T e le he alth: De finitions • Telehealth Services • Virtual Check-Ins • E-Visits 2

T e le he alth De finitions: Or iginating Site Authorized originating sites include: • Physician and practitioner offices • Hospitals • Critical Access Hospitals (CAHs) • Rural Health Clinics • Federally Qualified Health Centers • Hospital-based or CAH-based Renal Dialysis Centers (including satellites) • Skilled Nursing Facilities (SNFs) • Community Mental Health Centers (CMHCs) • Renal Dialysis Facilities • Homes of beneficiaries with End-Stage Renal Disease (ESRD) getting home dialysis • Mobile Stroke Units 3

T e le he alth De finitions: Distant Site Pr ac titione r s • Physicians • Nurse practitioners (NPs) • Physician assistants (PAs) • Nurse-midwives • Clinical nurse specialists (CNSs) • Certified registered nurse anesthetists • Clinical psychologists (CPs) and clinical social workers (CSWs) • Registered dietitians or nutrition professionals 4

Me dic ar e T e le he alth Be ne fits pr ior to COVID- 19 • Medicare coverage for telehealth services placed some requirements on: – Patient type (i.e., established or new) – Frequency of telehealth visits – Beneficiary location – Specific provider types • As a result of the SUPPORT Act, CMS increased flexibility for telehealth for substance use disorder beginning in 2020 5

T e le he alth: CMS Ac tions Dur ing Public He alth E me r ge nc y Blanket Waivers • Waivers and Flexibilities for Hospitals and Other Healthcare Facilities • Included Telehealth Services The Effective date for all blanket waivers will be retroactively applied as of March 1, 2020 Blanket waiver summary is available at: https://www.cms.gov/files/document/summary-covid-19- emergency-declaration-waivers.pdf Details for these waivers can be found on the CMS website: https://www.cms.gov/about-cms/emergency-preparedness- response-operations/current-emergencies/coronavirus- waivers 6

https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers

T e le he alth: Dur ing COVID- 19 PHE • Beneficiaries can get a wider range of healthcare services without traveling to a health care facility • Patient’s home can be an originating site . • Additional provider types can bill for certain services • RHCs and FQHCs can serve as distant site providers • Removed frequency limitations • Increase flexibility for waiving co-insurance and deductible 8

E xpa nde d T e le he a lth Be ne fits During COVID- 19 Outbre a k • Virtual Check-in and E-Visit • Addition of audio-only telehealth services • In-person and face-to-face visit requirements • Remote patient monitoring • Increase home health telehealth benefits 9

T e le he alth: Dur ing COVID- 19 PHE What can Medicare pay for? – Office . – Hospital – Other visits, including patient’s places of residence 10

T e le he alth: Dur ing COVID- 19 PHE What services can a Medicare beneficiary receive through telehealth? . • Evaluation and management visits (common office visits) • Mental health counseling • Preventive health screenings 11

T e le he alth: Dur ing COVID- 19 PHE Medicare Telehealth Visits • Waiving the video requirement for certain services • Expanded list of services available to patients • Furnished in broader circumstances • Available in all areas of the country • Any provider who can independently bill Medicare can provide telehealth services 12

T e le he alth: Dur ing COVID- 19 PHE Virtual Check-Ins • Practitioners may need to educate patients on the availability of this service • Can be provided to both new and established patients • No need for consent prior to each encounter 13

T e le he alth: Dur ing COVID- 19 PHE E-Visits • Expanded availability of codes so clinicians who normally may not independently bill Medicare for evaluation and management visits can now provide and bill for these services 14

T e le he alth: Dur ing COVID- 19 PHE Audio-Only Evaluation and Management or Assessment and Management Services • Furnished via telephone or online • For patients who do not have access to, or choose not to use, two-way audio/video technology • Initiated by patient • Additional clinician types can provide and bill for these services 15

Me dic ar e T e le he alth Se r vic e s (a s of Ma rc h 6, 2020) 16

Me dic aid T e le he alth Se r vic e s • Telehealth is viewed as a cost-effective alternative to the more traditional face-to-face way of providing medical care • States have broad flexibility to cover telehealth through Medicaid • Medical Codes: States may select from a variety of codes and modifiers to identify, track and reimburse for telehealth services. 17

Me dic ar e Advantage and T e le he alth • Starting in 2020, plans may offer more telehealth benefits than Original Medicare • Medicare beneficiaries should check with their plan regarding coverage details 18

https://telehealth.hhs.gov/

COVID- 19 T e le he alth Re sour c e s • COVID-19 Disaster Response Toolkit (3/12/20) • CMS Coronavirus Partner Virtual Toolkit (3/17/20) • General Telemedicine Toolkit (PDF) (3/20/20) • State Medicaid & CHIP Telehealth Toolkit (4/23/20) • https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine- health-care-provider-fact-sheet • https://www.cms.gov/files/document/medicare-telehealth-frequently- asked-questions-faqs-31720.pdf

Ge ne r al T e le he alth Re sour c e s • https://telehealth.hhs.gov/ • Telehealth Services Booklet (MLN901705): https://www.cms.gov/Outreach-and-Education/Medicare- Learning-Network- MLN/MLNProducts/Downloads/TelehealthSrvcsfctsht.pdf • Medicare.gov Telehealth Site: https://www.medicare.gov/coverage/telehealth 21

Contac t Infor mation Michelle Wineinger, Rural Health Coordinator Michelle.Wineinger@cms.hhs.gov

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