CMS updated the Medicare telehealth services list on Oct 14 with 11 new services to qualifying the services for Medicare reimbursement through the coronavirus pandemic emergency. The added new telehealth services cover some cardiac and pulmonary rehabilitation services, in addition to certain neurostimulator analysis and programming services.
These services added to the Medicare telehealth list were made in response to President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care.
CMS Administrator Seema Verma said, “Responding to President Trump’s Executive Order, CMS is taking action to increase telehealth adoption across the country. This revolutionary method of improving access to care is transforming healthcare delivery in America. President Trump will not let the genie go back into the bottle.”
Expanding Medicare Telehealth Services
The Medicare telehealth list categorizes the telehealth services Medicare will pay for through the duration of the coronavirus pandemic emergency. During COVID-19, CMS had added over 135 services to the list for a wide range of provider services, together with emergency department visits, primary inpatient and nursing facility visits, and discharge day management services.
The new Codes to be added:
- CPT code 93797: Cardiac rehab
- CPT code 93798: Cardiac rehab/monitor
- CPT code 93750: Interrogation vad in person
- CPT code 95970: Alys npgt w/o prgrmg
- CPT code 95971: Alys smpl sp/pn npgt w/prgrm
- CPT code 95972: Alys cplx sp/pn npgt w/prgrm
- CPT code 95983: Alys brn npgt prgrmg 15 min
- CPT code 95984: Alys brn npgt prgrmg addl 15
- HCPCS code G0422: Intens cardiac rehab w/exerc
- HCPCS code G0423: Intens cardiac rehab no exer
- HCPCS code G0424: Pulmonary rehab w exer
With these newly added codes, now Medicare will pay for 144 total services performed via telehealth under Medicare Physician Fee Schedule (MPFS).
At the start of the COVID-19, the use of telehealth in Medicare has increased significantly, with over 12.1+ million traditional Medicare beneficiaries received treatment via telehealth from providers between mid-March and mid-August 2020. 36 percent of Medicare beneficiaries have received telehealth services, CMS reported in their announcement.
As per preliminary data snapshot also revealed in the announcement, telehealth use increased among CHIP and Medicaid beneficiaries.
This primary CHIP and Medicaid data snapshot on telehealth utilization during the coronavirus pandemic showed that telehealth use among beneficiaries in the two programs increased by over 2,600+ percent in March to June 2020. The snapshot also showed that adults between the ages of 19 and 64 years received the most telehealth services during the start of the coronavirus pandemic emergency.
“The updated supplemental information is intended to help states strategically think through how they explain and clarify to providers and other stakeholders which policies are temporary or permanent,” CMS stated in the announcement. “It also helps states identify services that can be accessed through telehealth, which providers may deliver those services, the ways providers may use in order to deliver services through telehealth, as well as the circumstances under which telehealth can be reimbursed once the PHE expires.”
Click here to know more about the supplemental information.
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CMS added 11 new services to the Medicare telehealth list, including cardiac and pulmonary rehabilitation services and neurostimulator analysis and programming services. These additions support Medicare reimbursement during the COVID-19 public health emergency.
The expansion was in response to President Trump’s Executive Order on Improving Rural Health and Telehealth Access. The goal is to improve healthcare access for all Americans—especially in rural areas—by promoting telehealth adoption.
Newly added codes include:
CPT 93797 & 93798 – Cardiac rehabilitation
CPT 95970–95984 – Neurostimulator programming
HCPCS G0422–G0424 – Intensive cardiac and pulmonary rehab services
Between mid-March and mid-August 2020, over 12.1 million traditional Medicare beneficiaries used telehealth services. That’s about 36% of all Medicare beneficiaries, according to CMS data.
Telehealth usage among CHIP and Medicaid beneficiaries increased by over 2,600% between March and June 2020. Adults aged 19 to 64 were the primary users of these services during the pandemic.
