Breaking: CMS Addresses Society Concerns–Makes Sweeping Changes/Additions to Telehealth Services

Since the outbreak of the COVID-19 pandemic, the Society has asked the Centers for Medicare & Medicaid Services (CMS) to remove all barriers to providing visits in skilled nursing facilities via telehealth. On Monday, March 30, after many discussions with Society leaders, CMS did just that—essentially eliminating all barriers and adding services in other sites of care to the telehealth list. Importantly, all of these changes are backdated to March 1, 2020, so any billing that occurred prior to this release will be reimbursed.

The guidance released yesterday by CMS suspends all face-to-face regulatory visits and allows them to be done via telehealth.

Medicare Telehealth • Physician visits in skilled nursing facilities/nursing facilities: CMS is waiving the requirement in 42 CFR 483.30 for physicians and non-physician practitioners to perform in-person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options. (See this document toward the bottom of page 4.)

The Society has long advocated for the “once a month restriction on subsequent care codes 99307-99310” to be eliminated and said they must be eliminated during the COVID-19 pandemic.

CMS’ specific guidance states:

“A subsequent skilled nursing facility visit can be furnished via Medicare telehealth, without the limitation that the telehealth visit is once every 30 days (CPT codes 99307-99310).” See this document (bottom of page 2).

The Society is pleased that CMS listened to those concerns and removed this barrier.

Further, CMS added initial (99304-99306) and discharge services (99315/16) to the list of approved telehealth visits. Previously these visits had to be done in-person only.

CMS also addressed telehealth visits in other sites of care, adding codes for assisted living: domiciliary care/rest home/custodial care as well all home visits. Likewise, physical therapy and occupational therapy were added to the list. A complete list can be found here. Finally, CMS addressed hospice care as well, adding those services to the telehealth list and providing additional flexibility as explained here.

The Society welcomes and applauds these changes by the administration and looks forward to working together to continue to address the COVID-19 pandemic. To view the full list of changes please go here.