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CMS Looks Beyond COVID-19 For Telehealth Expansion

Centers for Medicare & Medicaid Services (CMS) has further expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the COVID-19 public health emergency (PHE) as of October 14, 2020. CMS is adding 11 new services to the Medicare telehealth services list and will begin paying eligible practitioners who furnish these services immediately and through the end of the PHE. The new telehealth services include neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services.

Here are the 11 additional services and their respective codes:

  • 93797: Cardiac rehab
  • 93798: Cardiac rehab/monitor
  • 93750: In-person ventricular assist device interrogation
  • 95970: Electronic analysis of implanted neurostimulator pulse without programming
  • 95971: Electronic analysis of implanted neurostimulator pulse generator/transmitter with programming
  • 95972: Electronic analysis of implanted neurostimulator pulse generator/transmitter
  • 95983: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; first 15 minutes face-to-face with physician or other qualified healthcare professional
  • 95984: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; each additional 15 minutes face-to-face with physician or other qualified healthcare professional
  • G0422: Intensive cardiac rehab with exercise
  • G0423: Intensive cardiac rehab, no exercise
  • G0424: Pulmonary rehab with exercise

With this further expansion, Medicare will pay for 144 services performed via telehealth. Some of them are being considered by CMS for addition to the permanent Medicare telehealth list.

CMS is also providing support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies to expand telehealth. CMS data shows that more than 34.5 million services were delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year. Thus, CMS released a new Supplement #1 to its State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version to guide states in strategically planning what services should be available and reimbursable through telehealth and for how long. Supplement #1 acknowledges that states are considering whether telehealth flexibilities should continue beyond the PHE on a more permanent basis, stating “states may also want to consider how these strategies may be used to support more permanent telehealth policies and services.” Supplement #1 provides helpful guidance for operationalizing telehealth strategies, particularly in the appendixes which include coding guidance, resources, common modalities, and a sample state Medicaid assessment/action plan.