U.S. Federal Actions Support Continued Telehealth Services for Medicare Beneficiaries

On March 15, 2022, President Biden signed into law the Consolidated Appropriations Act, 2022 (the "Act"), extending certain Medicare telehealth reimbursement flexibilities for 151 days following the end of the declared COVID-19 public health emergency. At the beginning of the pandemic, the Centers for Medicare & Medicaid Services ("CMS") implemented certain blanket waivers of Medicare telehealth coverage requirements. These waivers removed the geographic and originating site limitations, expanded the types of health care providers who can furnish telehealth services to Medicare beneficiaries, and allowed for the use of audio-only equipment to furnish certain telehealth services. The waivers were set to expire immediately upon expiration of the public health emergency, creating uncertainty for providers taking advantage of the waivers. With the passage of the Act, the waivers will now remain in effect for 151 days after the end of the public health emergency.

The Act followed actions by CMS earlier this year to expand and extend Medicare coverage for telehealth services. For instance, CMS expanded coverage of telehealth services as part of its annual Physician Fee Schedule. Most notably, CMS permanently expanded coverage for the diagnosis, evaluation, or treatment of certain mental health disorders to include services delivered to beneficiaries located in their homes (such that the geographic restrictions applicable to traditional telehealth services do not apply). In order for such services to be covered, an in-person, non-telehealth service must be furnished within six months prior to the first telehealth visit and at least once within 12 months of each subsequent telehealth service (unless an exception applies), and services must be distinguished and documented in the patient's medical record. CMS also permanently expanded coverage for audio-only telecommunications for mental health disorders when certain conditions are met. Specifically, the patient must be located at home, the provider must have the ability to utilize both audio and video communication, and the beneficiary must choose to utilize audio-only technology because they are incapable of or do not consent to using audio/video technology. 

Lawmakers have recently introduced other bills to further expand coverage for Medicare telehealth services. Such bills include the Telehealth Extension Act of 2021 (H.R. 6202) and the Telehealth Extension and Evaluation Act (S. 3593).