![]() Physicians will be reimbursed pursuant to the Physician Fee Schedule in the same amount as if they provided the service in-person. Also, physicians should use the place of service code they would have used if the service was provided in-person. ![]() Physicians providing services via telehealth should use the CPT code that best describes the nature of the care they’re providing, regardless of any other factors. CMS also added to the list of reimbursable Medicare telehealth services (now 80+), eliminated frequency limitations and other requirements, and clarified several payment rules. Payment for Medicare Telehealth Services Under Section 1834(m) of the Act: Medicare is now authorized to pay office, hospital, and other visits by physicians and other practitioners, provided via telehealth, to patients located anywhere in the country, including a patient’s residence. Section-by-Section Summary of the Rule for Ease of ReferenceĪ. An index to those fact sheets can be found here. Providers should refer to both the Rule and the blanket waivers for changes that may affect the provider, and the provision of services during the emergency.Īdditionally, CMS issued a series of provider-specific fact sheets that contain waiver and flexibilities information specific to that provider. The Rule will remain in place until the expiration or termination of the emergency.ĬMS has also issued a set of Emergency Declaration Blanket Waivers of Medicare program requirements that would otherwise be applicable to various participating providers. CMS also published a fact sheet with additional background information concerning the Rule. EST on June 1, 2020, and may revise the Rule in response to those comments, which is the basis for its “Interim Final” status. CMS is accepting comments on the Rule through 5:00 p.m. The Rule was made retroactively effective back to March 1, and was published in final form in the Federal Register on April 4. Other topics covered by the Rule involve independent laboratory testing, ambulance transports, home health orders, “under arrangements” for hospitals, and changes in various programs in order to place patient safety above cost considerations. Many of the changes deal with expanding provider capabilities through the use of telehealth and other remote communications technology in order to avoid risk of exposure to health care providers, patients, and the general public. The focus of the Rule is, in essence, “bending the rules” that are normally in place for providers so they can more readily treat patients during the public health emergency created by the COVID-19 pandemic (referred to herein as “the emergency” or “PHE”). The Centers for Medicare and Medicaid Services issued an Interim Final Rule (“Rule”) containing, in CMS’s own words, “a sweeping array of new rules and waivers of federal requirements to ensure that local hospitals and health systems have the capacity to absorb and effectively manage potential surges of COVID-19 patients.”
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