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Following on the heels of a presidential executive order focused on “Improving Rural Health and Telehealth Access,” the proposed 2021 Medicare Physician Fee Schedule includes a number of important telehealth policy proposals. Highlights include:
- Proposed policy changes to maintain certain elements of the various telehealth flexibilities authorized on a temporary basis during the COVID-19 public health emergency (PHE), with some proposals lasting until Dec. 31, 2021, or the end of the calendar year in which the public health emergency ends, whichever is later. Among the services the Centers for Medicare and Medicaid Services (CMS) is proposing to add to the Medicare telehealth list:
- GPC1X - Visit Complexity Associated with Certain Office/Outpatient E/Ms
- 99XXX - Prolonged Services
- 99334, 99335 - Domiciliary, Rest Home, or Custodial Care Services
- 99347, 99248 - Home Visits
- A proposal to create a temporary category of criteria for adding services to the list of Medicare telehealth services. The below are intended to be used during the COVID-19 PHE and will remain on the list through the calendar year in which the PHE ends.
- 99336, 99337 - Domiciliary, Rest Home, or Custodial Care Services
- 99349, 99350 - Home Visits, Established Patient
- 99281, 99282, 99283 - Emergency Department Visits
- 99315, 99316 - Nursing Facilities Discharge Day Management
- 96130, 96131, 96132, 96133 - Psychological and Neuropsychological Testing
- CMS is not proposing to continue separate payment beyond the PHE for the audio-only telephone E/M services established in the March 31 COVID-19 interim-final rule. However, the Agency is seeking feedback on developing coding and payment for such a service.
- A proposal to allow direct supervision to be provided using real-time, interactive audio and video technology (excluding telephone that does not also include video) through Dec. 31, 2021.
Additional Resources:
CMS Releases Proposed 2021 Medicare Physician Fee Schedule and Hospital Outpatient Rules
Proposed 2021 Quality Payment Program Highlights
