Orthopedic Coding Alert

Question: Will the recent telehealth expansion rules expire when the public health emergency (PHE) ends?

New Jersey Subscriber

Answer: Maybe. The Centers for Medicare & Medicaid Services (CMS) published two interim final rules in March and May that streamlined telehealth and gave clinicians more care options with a plethora of 1,135 waivers in place as part of the public health emergency (PHE).

“Most of these regulatory flexibilities are set to sunset upon the expiration or termination of the PHE,” warns international law firm Dentons in online analysis. However, if information in a proposed rule becomes finalized, some of the expansion may become permanent. “The CY 2021 PFS proposed rule includes proposals to maintain an expanded list of Medicare-covered telehealth services and remote service flexibilities until the end of the CY in which the COVID-19 PHE ends, or in some cases beyond, and to clarify existing policies for remote services,” the Dentons’ attorneys note.

“Several types of services would be permanently approved for delivery via telehealth, including traditional home visits for evaluating and managing patient treatment and certain provider visits for patients with cognitive impairments,” says New York-based attorney Ada Kozicz with Rivkin Radler in the Rivkin Rounds blog.

“CMS believes that this expansion will provide enough time for CMS and key stakeholders to consider whether such services should be permanently approved for delivery via telehealth,” Kozicz says.

A few of the telehealth-related proposed rule highlights include:

• Permanently adding some services from the Medicare telehealth list.
• Creating a temporary addition list through the PHE called “Category 3.”
• Cutting frequency limits for skilled nursing facilities (SNFs).
• Permitting direct supervision using real-time, interactive audio, and video technology (excluding telephone that does not also include video) through Dec. 31, 2021.

Important: The CARES Act temporarily removed geographic and originating site barriers for Medicare telehealth services. “The proposed rule does not address these provisions because CMS is limited by statute and cannot permanently expand the list of telehealth providers. CMS notes that making these flexibilities permanent requires an act of Congress,” explains Miranda Franco, senior policy advisor with Holland & Knight LLP in Washington D.C., in a blog post.