Medicare Updated Telehealth Factsheet

Recently, the Centers for Medicare and Medicaid Services (CMS) updated and released their Medicare Learning Network (MLN) factsheet on Telehealth Services. Pre-COVID, CMS published an updated Telehealth Factsheet annually, although throughout the course of COVID the factsheet had been updated less frequently as temporary policy changes made it difficult to keep pace.  Earlier this year, the factsheet was taken down and had been listed as unavailable on the CMS website for the past few months.  Presumably, CMS was working to update it with the most recent telehealth policy changes given the extension of many of the COVID telehealth flexibilities until December 31, 2024 due to the passage of the Consolidated Appropriations Act, 2023. Some key clarifications made in the updated factsheet include:

• Through December 31, 2024, all patients can get telehealth wherever they’re located. They don’t need to be at a specific type of originating site, and there aren’t any geographic restrictions.
• After December 31, 2024:
  • For non-behavioral or mental telehealth, there may be originating site requirements and geographic location restrictions
  • For behavioral or mental telehealth, all patients can continue to get telehealth wherever they’re located, with no originating site requirements or geographic location restrictions if certain conditions are met
• Through December 31, 2024, all providers who are eligible to bill Medicare for professional services can provide distant site telehealth.
• Providers can use audio-only telehealth for some non-behavioral or mental telehealth through December 31, 2024.
• CMS requires patient consent for all care management and virtual communication services, including non-face-to-face services. Consent can be obtained at the same time a provider initially provides the services. The person getting consent can be an employee, independent contractor, or leased employee of the billing practitioner.
• Starting July 1, 2023, providers must report the use of telehealth technology (see factsheet for G-Codes) in providing home health (HH) services on HH payment claims.
• Through December 31, 2024:
  • Telehealth can be used to conduct hospice care eligibility recertification
  • For behavioral or mental telehealth, providers don’t have to conduct an in-person visit within 6 months of the initial telehealth visit or annually thereafter
  • CMS has extended the Acute Hospital Care at Home Program.

In addition to adding the information above, CMS also made significant deletions from the previous version of their factsheet, including the permanent eligible originating site list, explanation of the requirement for patients to be located in rural areas and the permanent distant site provider list.  In this current version, CMS merely mentions in one bullet point that originating site requirements and geographic restrictions for non-behavioral or mental telehealth ‘may’ go back into effect after Dec. 31, 2024.  This was likely done for the sake of clarity so as not to confuse providers between current reimbursement policy (effective for the most part until December 31, 2024) and permanent policy (which will go into effect on Jan. 1, 2025).  It could also indicate an expectation that permanent policy (which is in statute) could potentially be amended before Jan. 1, 2025.  For more on current Medicare telehealth policy, see the MLN Telehealth Services Factsheet.