Providers push to extend telehealth policies and waivers beyond COVID-19

The American College of Physicians (ACP) recently wrote a letter to CMS Administrator Seema Verma recommending that several telehealth flexibilities remain in effect for a period after the novel coronavirus (COVID-19) public health emergency (PHE) is lifted.

Several Medicare policies that expand patient access to telehealth services are due to expire at the conclusion of the PHE. According to the ACP, a quick reversal of these policies could negatively impact office workflows as well as efforts to mitigate spread of the virus and prevent future outbreaks. The ACP, therefore, is encouraging CMS to keep these policies in place for a period after the PHE ends to maintain and improve upon patient-centered care delivery.

In its letter, the ACP recommends that the following policies and waivers remain in effect through at least the end of 2021:

• Facility fee payment for provider-based departments: CMS is allowing hospitals to bill a facility fee when the patient is an established patient of a provider-based outpatient department and receives care via telehealth services at their home. According to ACP, risk-based assessments are needed before these types of facilities are expected to shift back to regular face-to-face visits; therefore, CMS should extend this policy possibly through the end of 2021.
• Flexibilities in direct supervision by physicians at teaching hospitals: CMS should maintain these modifications for some time after the PHE ends, until supervising physicians are confident that they can control the spread of infection rates, according to ACP.
• Geographical site restriction waivers: ACP recommends that CMS permanently extend the policy to lift geographical and originating-site restrictions after the conclusion of the PHE.
• Interstate licensure flexibility for telehealth and promotion of state-level action: CMS issued a temporary waiver that allows physicians to provide telehealth services across state lines. ACP recommends these changes remain in place at least through the end of 2021.
• Pay parity for audio-only and telehealth services: ACP encourages CMS to maintain pay parity between telephone E/M claims and in-person E/M visits and between all telehealth and in-person visits after the PHE is lifted.
• Revised policies for remote patient monitoring (RPM) services: CMS expanded access to RPM CPT® codes by allowing physicians to bill them for both new and established patients during the PHE. ACP encourages CMS to maintain these modifications at least through the end of 2021.
• Telehealth cost-sharing waivers: ACP recommends that CMS continue to provide flexibility in the Medicare and Medicaid programs for physician practices to reduce or waive cost-sharing requirements for telehealth services.