Proposed 2019 Physician Fee Schedule Rule Contains Significant Telehealth Provisions

Continues progress by Congress and CMS in expanding access to telehealth under Medicare

July 17, 2018

The Centers for Medicare and Medicaid Services’ (CMS) proposed 2019 Physician Fee Schedule rule released last week contains several proposals to expand access to telehealth services and telehealth-related services for Medicare beneficiaries.

Specifically, CMS proposes to begin paying for the following services effective January 1, 2019:

  • Virtual Check-In for Established Patients. CMS proposes to permit a physician or other health care professional qualified to perform an evaluation and management (E/M) service to bill for a brief, non-face-to-face check-in with an established patient via communication technology to assess whether the patient’s condition necessitates an office visit.
  • Remote Evaluation of Pre-Recorded Patient Information. CMS proposes to create specific coding that describes the remote professional evaluation of patient-transmitted information conducted via pre-recorded “store and forward” video or image technology.
CMS also proposes adding Healthcare Common Procedure Coding System (HCPCS) codes for certain prolonged preventive services to the list of telehealth services that are covered under Medicare.

These proposals follow other recent actions taken by Congress and CMS to expand access to telehealth and telehealth-related services for Medicare beneficiaries. As reported in February’s Valued Voice, when Congress passed the Bipartisan Budget Act of 2018, it expanded access to Medicare telehealth stroke services for patients located in a rural area. It also expanded access to Medicare telehealth dialysis services for patients located in their homes. Similarly, in the 2018 Physician Fee Schedule rule, CMS added several items to the list of telehealth services covered under Medicare, and permitted professionals to bill separately for remote patient monitoring.

For more information, contact WHA at 608-274-1820.
 

This story originally appeared in the July 17, 2018 edition of WHA Newsletter