CMS’ April 14, 2020 “Office Hours” Discussed the Promotion of Telehealth in Medicare

April 16, 2020

On April 14, 2020, the Centers for Medicare & Medicaid Services (“CMS”) hosted another “Office Hour” to allow hospitals, health systems and providers the opportunity to ask CMS officials questions pertaining to CMS’ temporary actions during the COVID-19 pandemic. The complete recording of the April 14, 2020 “Office Hours” will be made available here . Below are some highlights from CMS’ April 14, 2020 “Office Hour”:

Health Care Providers, Generally

  • In response to a question regarding whether Medicare will pay for telehealth conducted with audio only, CMS noted that in the Interim Final Rule, telephone evaluation and management visits are available for payment under physician fee schedule (“PFS”). CMS expects to release more information about this issue soon.

  • CMS noted that guidelines pertaining to the level of time for telehealth visits can be found, among other locations, on the PFS website.

  • In response to a question whether health care providers may provide telehealth services and bill for such services if later approved by CMS, CMS mentioned that many of its changes are retroactive.

Physical, Occupational and Speech Therapy Providers

  • CMS commented that it is aware of telehealth payment questions raised by physical, occupational and speech therapy providers in response to the COVID-19 public health emergency. CMS is considering changes related to such services based on CMS’ new authorities under the CARES Act.

  • Under current policy, occupational therapy and physical therapy providers cannot conduct a telehealth visit and bill “incident to”. CMS has yet to make changes permitting occupational therapists or physical therapists to provide and bill services through telehealth. 

Rural Hospitals
  • CMS stated that it will review questions related to rural hospital coalitions and rural hospital bed limitations.

Skilled Nursing Facilities

  • Using its authority under Section 1812(f) of the Social Security Act, CMS has waived the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility stay for patients who experience dislocations, or are otherwise affected by COVID-19. Since this is a blanket waiver, no additional documentation would be needed to waive the 3-day prior hospitalization stay requirement. CMS stated that the 2-midnight rule still applies.  

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