Query: Has the Medicare telemedicine record modified for 2022?

Reply: As Facilities for Medicare and Medicaid Providers (CMS) continues to judge the inclusion of telehealth companies that had been quickly added to the Medicare telehealth companies record throughout the COVID-19 public well being emergency, they’ve finalized that sure companies added to the Medicare telehealth companies record will stay on the record by means of December 31, 2023.

This can enable further time for CMS to judge whether or not every service must be completely added to the Medicare telehealth companies record.

CMS finalized that they’ll lengthen, by means of the tip of CY 2023, the inclusion on the Medicare telehealth companies record of sure companies added quickly to the telehealth companies record that might in any other case have been faraway from the record as of the later of the tip of the COVID-19 PHE or December 31, 2021. In addition they have prolonged inclusion of sure cardiac and intensive cardiac rehabilitation codes by means of the tip of CY 2023. This can enable for extra time for CMS to collect information to resolve whether or not or not every telehealth service will likely be completely added to the Medicare telehealth companies record.

Moreover, CMS is adopting coding and cost for an extended digital check-in service on a everlasting foundation.

Part 123 of the Consolidated Appropriations Act (CAA) eliminated the geographic restrictions and added the house of the beneficiary as a permissible originating web site for telehealth companies furnished for the needs of analysis, analysis or remedy of a psychological well being dysfunction. Part 123 requires for these companies that there have to be an in-person, non-telehealth service with the doctor or practitioner inside six months previous to the preliminary telehealth service and an in-person, non-telehealth go to have to be furnished no less than each 12 months for these companies.

Exceptions to the in-person go to requirement could also be made based mostly on beneficiary circumstances (with the rationale documented within the affected person’s medical report), and that extra frequent visits are additionally allowed below the coverage, as pushed by medical wants on a case-by-case foundation.

CMS has amended the present definition of interactive telecommunications system for telehealth companies (which is outlined as multimedia communications gear that features, at a minimal, audio and video gear allowing two-way, real-time interactive communication between the affected person and distant web site doctor or practitioner) to embody audio-only communications expertise when used for telehealth companies for the analysis, analysis or remedy of psychological well being issues furnished to established sufferers of their houses below sure circumstances.

CMS is limiting the usage of an audio-only interactive telecommunications system to psychological well being companies furnished by practitioners who’ve the potential to furnish two-way, audio/video communications, however the place the beneficiary isn’t able to, or doesn’t consent to, the usage of two-way, audio/video expertise.

CMS additionally finalized a requirement for the usage of a brand new modifier for companies furnished utilizing audio-only communications, which might serve to confirm that the practitioner had the potential to offer two-way, audio/video expertise, however as an alternative, used audio-only expertise attributable to beneficiary selection or limitations. They’re additionally clarifying that psychological well being companies can embody companies for remedy of substance use issues (SUDs).

The brand new modifier — Modifier 93 – Synchronous Telemedicine Service Rendered Through Phone or Different Actual-Time Interactive Audio-Solely Telecommunications System – is efficient January 1, 2022.

“Synchronous telemedicine service” is outlined as a real-time interplay between a doctor or different certified well being care skilled (QHP) and a affected person who’s situated away at a distant web site from the doctor or different QHP. The totality of the communication of data exchanged between the doctor/QHP and the affected person throughout the course of the synchronous telemedicine service have to be of an quantity and nature that’s adequate to satisfy the important thing elements and/or necessities of the identical service when rendered through a face-to-face interplay.

Renee Dowling is a compliance auditor for Sansum Clinic, LLC, in Santa Barbara, California.


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