Posted Sunday, May 9, 2021
Prior to the public health emergency announced in the wake of COVID-19, Medicare restricted reimbursement for telehealth visits to a few limited circumstances. To reduce in-person visits during the pandemic, however, Medicare telehealth benefits were expanded through an 1135 waiver for the duration of the public health emergency to most healthcare providers. However, home health agencies remain outside fully reimbursed telehealth services.
Formerly, the Centers for Medicare and Medicaid Services (CMS) had restricted telehealth payments to patients that lived in rural areas or for services rendered by a provider from a healthcare setting such as a hospital or physician’s office. The waiver permits most providers to bill for telehealth services, and it expanded the types of HCPs who can perform telehealth services to include physical therapists, occupational therapists, and speech therapists. Under the current waiver, home health agencies cannot bill for audio or audio/video services, and they must capture telehealth services as administrative costs.
Some other changes under the waiver allow telehealth providers to:
- Conduct telehealth with patients in their homes who are located outside designated rural areas
- Practice remote care, even across state lines, through telehealth
- Deliver care to both established and new patients through telehealth
- Bill for telehealth services (both video and audio-only) as if they were provided in person
Patients and providers have found that telehealth offers important advantages such as limiting in person contact and reducing the need for personal protective equipment to reduce transmission of the virus. The advantages during the pandemic led to a 2500% increase in telehealth visits between Spring 2019 and Spring 2020. Due to the successful implementation of telehealth for COVID-19, remote patient care using audio and audio/video visits is expected to become an ongoing reimbursed service for Medicare patients.
Proposed legislation, the Home Health Emergency Access for Telehealth (HEAT) act, would extend telehealth reimbursement during the public health emergency to home health agencies. The bill balances telehealth by requiring at least 50% of all billable services be provided in person during each 30-day billing cycle. It also requires that home health patients must consent to the use of telehealth services.
To find out more about how you can leverage the advantages of telehealth and its reimbursement strategies for your agency, please contact Corridor at 1-866-263-3795.
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