The Centers for Medicare & Medicaid Services on 14th Oct 2020, announced that it has expanded the list of telehealth services that Medicare will pay for during the COVID-19 public health emergency. Medicare will begin paying eligible practitioners for these 11 newly approved telehealth services delivered via telehealth, including certain cardiac rehabilitation and monitoring services. Since the emergency was declared i.e., March 2020, CMS has added more than 135 new virtual care services to what’s covered under fee-for-service Medicare, making it 144 total covered virtual care services.
Widespread Adoption of Telehealth Services
The agency has observed widespread adoption of telehealth services, especially in the earlier months of the pandemic. To everybody’s surprise, Medicare has seen skyrocketing adoption too. As per CMS, in between mid-March and mid-August, more than 36% of people in traditional Medicare had used a virtual visit which makes more than 12.1 million beneficiaries. As compared to last year, in between March and June, explosive 2600% growth in the use of telehealth by Medicaid and CHIP beneficiaries was recorded by CMS. The agency has released a new supplement to its toolkit to guide states in expanding the use of telehealth.
CMS also released a snapshot of how the country’s 91.8 million Medicaid and Children’s Health Insurance Program beneficiaries were taking to digitally delivered care. Most of the beneficiaries were adults aged 19 to 64, followed by children and older adults. This telehealth adoption peaked in April for nearly all states and has been declining slowly after May.
New Telehealth Services
The 11 newly added telehealth services include electronic analysis of an implanted neurostimulator pulse generator; non-invasive physiologic studies and procedures; physician services for outpatient cardiac rehab; intensive cardiac rehab, with or without continuous ECG monitoring; and pulmonary rehab, including exercise. As mentioned earlier, Medicare will begin paying eligible practitioners who provide these newly added telehealth services effective immediately and through the duration of the public health emergency.
The 11 telehealth services and their respective codes are as follows:
- CPT 93797: Cardiac rehab
- CPT 93798: Cardiac rehab/monitor
- CPT 93750: In-person ventricular assist device interrogation
- CPT 95970: Electronic analysis of implanted neurostimulator pulse without programming
- CPT 95971: Electronic analysis of implanted neurostimulator pulse generator/transmitter with programming
- CPT 95972: Electronic analysis of implanted neurostimulator pulse generator/transmitter
- CPT 95983: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by the physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; first 15 minutes face-to-face with a physician or other qualified healthcare professional
- CPT 95984: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by the physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; each additional 15 minutes face-to-face with a physician or other qualified healthcare professional
- CPT G0422: Intensive cardiac rehab with exercise
- CPT G0423: Intensive cardiac rehab, no exercise
- CPT G0424: Pulmonary rehab with exercise
You can find the full list of services payables under Medicare when provided via telehealth on the CMS website.
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