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CMS Announces COVID-19 Telehealth Waivers for Medicare Program

March 19, 2020

The federal Centers for Medicare & Medicaid Services (CMS) this week issued information on waivers of Medicare telehealth restrictions for the duration of the COVID-19 pandemic. 
The major changes announced March 17 for Medicare telehealth include:
  • Geographic restrictions placed on Medicare telehealth are waived. Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings.
  • Restrictions on location of the patient are waived. Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any health care facility and in their home.
  • Payment for Medicare telehealth visits will be the same as in-person visits. The Medicare coinsurance and deductible will generally apply to these telehealth services. However, the HHS Office of Inspector General (OIG) is providing flexibility for health care providers to reduce or waive cost-sharing for telehealth visits paid by federal health care programs.
  • HHS will not conduct audits to ensure that a prior patient-provider relationship existed for claims submitted during this public health emergency.
  • HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies.
In the March 13 declaration by the President of a national emergency, the Secretary issued a 1135 waiver for “requirements that physicians or other health care professionals hold licenses in the state in which they provide services if they have an equivalent license from another state.” However, CMS did not issue further guidance in the March 17 information on how this will be implemented.
CMS also reminds providers that Medicare virtual check-ins and e-visits are already available as other means to communicate with patients without face-to-face contact. These modes of communication are explained further in the CMS fact sheet.
CMS has also prepared a “Frequently Asked Questions” document for Medicare telehealth that contains useful information.
For questions concerning telehealth reimbursement during the COVID-19 pandemic, contact WHA Vice President of Policy Laura Rose

This story originally appeared in the March 19, 2020 edition of WHA Newsletter