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CMS provides guidance on eligible telehealth services for 2021

The United States Centers for Medicare and Medicaid Services (CMS) recently released a publication outlining telehealth services that will be eligible for coverage in 2021. The agency’s list includes 39 telehealth-eligible services, such as:

  • Preventive Care and Screening appointments for depression as well as child and adolescent Major Depressive Disorder suicide risk assessments
  • Functional Status Assessments for hip and knee replacement procedures
  • Primary care prevention intervention services provided by primary care physicians and dentists
  • Childhood immunization status appointments
  • Breast, cervical and colorectal cancer screening appointments
  • Controlling high blood pressure appointments

The list, the Medicare Telehealth Service list, is subject to change.

The agency also clarified that certain services were not eligible for coverage. These include a preventative care and screening appointment for high blood pressure and follow-up as well as body mass index screening appointments. According to the CMS, these screening services require therapy, treatment or assessments that cannot be adequately completed through the use of telehealth services.

Having an awareness of the list is important as it provides some guidance for how services can proceed next year. A failure to abide by the CMS’ rules can result in inappropriate billing. Inappropriate billing can lead to allegations of health care fraud and result in a federal investigation. If the investigation leads to evidence of fraud, those involved can face ramifications from their local licensing board. This could lead to a suspension or revocation of one’s medical license. They can also face criminal charges which can result in serious financial penalties as well as potential imprisonment.

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