By Stacey LaCotti, Customer Experience Strategist, Alpha II
and Crystal Ewing, Director, Product Management — Revenue Cycle, eSolutions
April 30, 2020, marked widely anticipated changes for providers of all types by the Centers for Medicare & Medicaid Services (CMS), which announced a massive relaxation in previously held telehealth regulations in response to the COVID-19 Public Health Emergency (PHE).
This historic policy modification by CMS recognizes telehealth and virtual care as important tools for providers who must offer necessary patient care while also keeping staff safe during this rapidly evolving pandemic. These temporary changes will apply immediately across the entire U.S. healthcare system for the duration of the emergency declaration, according to CMS.
While this is good news for providers, these changes also bring about a flurry of new guidance and a great deal of information you’ll need to keep top of mind in order to make sure your organization is operating according to these new requirements. We break things down in this post.
Expanded List of Telehealth Services Covered
Prior to the announcement of the blanket waiver, only physicians, nurse practitioners, physician assistants and other specified providers could deliver Medicare-covered telehealth services. The new blanket waiver removes these restrictions.
And – according to an April 30 press release – until now, CMS only added new services to the list of Medicare services that may be provided via telehealth using its rulemaking process. “CMS is changing its process during the emergency, and will add new telehealth services on a sub-regulatory basis, considering requests by practitioners now learning to use telehealth as broadly as possible. This will speed up the process of adding services,” the release states.
CMS provides a full list of telehealth services on its website.
New Waiver Allows More Options for Delivering E&M Service
Effective March 1, 2020, CMS is waiving telehealth audio and video technology requirements for certain services. This waiver allows for a broad range of clinicians, including physicians, to provide certain telephone E&M, behavioral health counseling, and education services using audio-only equipment.
Practitioners can use devices that have audio and video capabilities, such as cell phones and tablets, to provide services during the PHE. The Office of Civil Rights also has issued guidance allowing covered healthcare providers to use popular video chat applications – including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video or Skype – to provide telehealth without risk of penalty for non-compliance with HIPAA Rules.
CMS has broadened the list of services and is allowing for the inclusion of many behavioral health and patient education services. “CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020,” according to the release.
Expanded List of Clinicians and Facilities Reimbursed for Telehealth
For the duration of the PHE, CMS is lifting limitations on the types of care providers who can be reimbursed. Now, physical and occupational therapists, licensed clinical social workers (LCSW), clinical psychologists and speech language pathologists are eligible for reimbursement, and federally qualified health clinics and rural health clinics will be reimbursed for providing telehealth services.
The Future of Telehealth
There’s no doubt that the COVID-19 pandemic has fundamentally shifted the understanding of our national healthcare system, and it’s very likely that the changes we see during an emergency might have lasting effects on how providers approach patient care in the future.
It’s also clear that telehealth plays a pivotal role in these shifts – and the current PHE has pressed fast-forward on so many hotly debated issues surrounding telehealth services.
Telehealth presents challenges in implementation, finances and policy changes. But it also presents incredible opportunities for patients and providers.
Providers looking for a revenue cycle partner who is prepared to take the journey, to support expansion of policy guidelines and to provide real-time, up-to-date educational information should know that eSolutions is here to help. Our solutions offer providers the technology to minimize the manual work you may be facing – including eligibility verification of telehealth visits and expanding claim edits to promote correct coding methodologies and ensure clean claims are submitted, which reduces unnecessary rework from underpayments and denials.
If your organization is struggling under the massive telehealth shifts taking place, just reach out using the form on this page. We’re here to help you navigate these unprecedented changes so you can focus on what’s most important – caring for patients.