Aug 17, 2023 Daniel Tashnek, JD In the proposed role, CMS proposed to clarify that it is permissible to bill for RPM or remote therapeutic monitoring services, but not both at the same time. The Centers for Medicare & Medicaid Service (CMS) recently published its 2024 physician fee schedule (PFS) proposed rule. One subject receiving a fair […]
§ 411.15 Particular services excluded from coverage. Link to an amendment published at 88 FR 53345, Aug. 7, 2023. The following services are excluded from coverage: (a) Routine physical checkups such as: (1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening […]
2023: New Federal Developments There were no new federal developments in the last month. 2023: New State-Level Developments State Activity Illinois Illinois passed S.B. 1913, which requires Medicaid FFS and Medicaid managed care plans to provide coverage of mental health services, substance use disorder treatment, and ‘behavioral telehealth services’. Requires Medicaid FFS and Medicaid managed care plans […]
At a Glance The annual Medicare physician payment rule is upon us, proposed July 13, 2023, for calendar year (CY) 2024 and open for public comment through September 11. Each year, the couple-of-thousand-page rule makes modifications to how Medicare pays physician and nonphysician providers for their services, including for telehealth services. In recent years, the physician […]
Over the past several years, the Centers for Medicare and Medicaid Services (CMS) has expanded payment for care management and remote monitoring services in an effort to recognize and pay for non-face-to-face services that improve care coordination for Medicare beneficiaries. In connection with the calendar year 2024 Medicare Physician Fee Schedule (MPFS) proposed rule, CMS […]
May 24, 2023 – Earlier this month, a group of six United States House representatives introduced the Protecting Rural Telehealth Access Act, which intends to maintain regional telehealth access and Medicare coverage flexibilities enacted during the COVID-19 pandemic. The expansion of telehealth that took place during the COVID-19 pandemic helped boost access to care, including in rural areas. […]
May 22, 2023 – A new report from the Center for Connected Health Policy (CCHP) found that various changes in telehealth policies related to Medicaid reimbursement, private-payer laws, and professional requirements occurred at the state level in 2023. Encompassing the period of January to March 2023, this spring report followed the standard process of organizing information under three headings: […]
Friday, January 6, 2023 Introduction On December 29, 2022, President Biden signed the Consolidated Appropriations Act, 2023 (the “Act”). The Act provides for nearly $1.7 trillion in funding across a range of domestic initiatives, including certain appropriations to healthcare and related programs. In addition to funding, the Act modifies certain telehealth provisions, expands and extends components […]
For healthcare providers treating some of the most underserved populations and communities, the end of the COVID-19 public health emergency is pretty bleak. Federal waivers expanding access to and coverage of telehealth will end with the PHE, forcing them to curtail or even end programs that had seen quite a bit of success over the […]
Telehealth is a natural fit to cover healthcare gaps in rural and frontier locations. But the nature of rural living often means difficulty accessing the tools and resources needed for a successful and sustainable telehealth practice. On this page: Internet access for rural telehealth patients and providers Equipment and technology access for rural telehealth Solutions […]
Preparation is critical for patients who are new to receiving care through telehealth. Rural patients often have high levels of healthcare needs, but see healthcare providers less than their urban counterparts. In short, the people who need healthcare the most aren’t always getting it. Telehealth can be that bridge for rural patients to get the […]
Billing and reimbursement for rural and frontier telehealth services is, in many ways, no different than any other healthcare service. There are also some stark differences. On this page: Medicare and Medicaid billing reimbursement Medicare billing guidance Medicare and Medicaid billing reimbursement The Centers for Medicare & Medicaid Services Office of Minority Health focuses on rural […]
Save time and avoid frustration by planning your telehealth workflow in advance. On this page: Get to know your community Create a business plan Market and advertise your telehealth services Evaluate your telehealth program A successful and sustainable telehealth practice in a rural area needs careful planning from the early research through implementation. We can […]