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

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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

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T e le he alth De finitions: Distant Site Pr ac titione r s

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• 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

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

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T e le he alth: CMS Ac tions Dur ing Public He alth E me r ge nc y

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Blanket Waivers

• Waivers and Flexibilities for Hospitals and Other Healthcare Facilities
• Included Telehealth Services

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

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

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

.

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E xpa nde d T e le he a lth Be ne fits During COVID- 19 Outbre a k

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• 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

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

.

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T e le he alth: Dur ing COVID- 19 PHE

What services can a Medicare beneficiary receive through telehealth?

• Evaluation and management visits (common
• ffice visits)
• Mental health counseling
• Preventive health screenings

.

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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

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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

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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

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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

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Me dic ar e T e le he alth Se r vic e s

(a s of Ma rc h 6, 2020)

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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.

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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

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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

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• 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

Contac t Infor mation

Michelle Wineinger, Rural Health Coordinator Michelle.Wineinger@cms.hhs.gov

Que stions?