The United States Center for Medicare and Medicaid Services (CMS) recently announced it will expand coverage for many telehealth services that received coverage as a result of the Public Health Emergency (PHE). This PHE was issued by the federal government in response to the COVID-19 pandemic.
What about the originating site requirement?
Unfortunately, the changes are not permanent and the American Medical Association (AMA) states they did not get all the requested updates. The burdensome originating site requirements, for example, will likely reappear in the future. The originating site requirement essentially limits many of the benefits of telehealth services. This requirement does not allow the patient to receive coverage for telehealth services if the patient makes the call while in their home. The patient only qualifies for coverage if they get the telehealth services while at a health care facility.
The federal government temporarily waived this requirement with the Coronavirus Aid, Relief and Economic Security (CARES) Act passed in 2020. As a result, at least during the pandemic, patients in rural and urban areas alike received coverage for telehealth services well in the comfort and safety of their own home.
Medical organizations like the AMA continue to push for the removal of this burdensome requirement. However, the CMS has stated that it does not have the authority to make these changes. Instead, greater legislative action is required.
How long will CMS coverage for telehealth services last?
Overall, recent changes have expanded coverage. The CMS has added a number of codes for various telehealth services. Some of these services will remain while the PHE is in effect, some will continue through the calendar year the PHE was in effect, while others are permanent.