Home Health & Hospice Week

Stay tuned for technical details as Jan. 1 implementation date nears.

“Why do it the easy way when you can do it the hard way” seems to be CMS’ motto at times. The latest example is in the 2023 home health final rule’s telehealth reporting provisions.

In the proposed rule back in June, the Centers for Medicare & Medicaid Services proposed using three new G codes for telehealth reporting. HHAs would use the codes to identify when they furnish home health services using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system; furnish synchronous telemedicine via telephone or other real-time interactive audio-only telecommunications system; and collect physiologic data digitally stored and/ or transmitted by the patient to the HHA (in other words, remote patient monitoring).

CMS wanted to start collecting the data on a voluntary basis by Jan. 1, and on a mandatory basis by July 1.

HHAs commenting on the rule were cautiously positive about the idea, but had a lot of suggestions for improvement — none of which CMS took.

For example: Some commenters deemed the timeline too tight and said it should be pushed back (see HHHW, Vol. XXXI, No. 37). In the final rule released on Oct. 31, CMS on one hand says “we will issue program instruction outlining the use of new codes for the purposes of tracking the use of telecommunications technology under the home health benefit with sufficient notice to enable HHAs to make the necessary changes in their electronic health records and billing systems.” But on the other hand, it sticks with the Jan. 1/July 1 timeframe, which means that “sufficient notice” deadline has pretty much already passed.

CMS doesn’t provide any commentary when rejecting ideas such as using a modifier for existing billing codes rather than new G codes and paying HHAs directly for their telehealth services.

For now: CMS does reveal a detail about code usage in the rule, though. Some commenters suggested aides could effectively use telehealth too. “While CMS maintains that the use of telecommunications technology would generally not be appropriate for home health aide services, at this time, we will not limit the use of these G-codes to any particular discipline,” the final rule says.