The Centers for Medicare and Medicaid Services (CMS) have recently updated and released the factsheet on Telehealth Services. Historically, CMS published this Telehealth Factsheet annually pre-COVID, but the frequency of updates was reduced during the COVID era due to temporary policy changes. The Medicare telehealth factsheet 2023 has been updated to reflect the latest telehealth policy changes in light of the extension of COVID telehealth flexibilities until December 31, 2024. This document is of particular note as it is included in many Telehealth.org training programs designed to help clinicians maximize their reimbursement opportunities.
Key Updates to the Medicare Telehealth 2023 Factsheet
Through December 31, 2024:
All patients can access telehealth without specific originating site requirements or geographic restrictions
After December 31, 2024:
Non-behavioral or mental telehealth may have originating site requirements and geographic location restrictions.
If certain conditions are met, behavioral or mental telehealth will continue without originating site requirements or geographic location restrictions.
Audio-only telehealth is available for non-behavioral or mental telehealth through December 31, 2024.
Patient consent is required for all care management and virtual communication services, including non-face-to-face services.
Starting July 1, 2023: Providers must report the use of telehealth technology in providing home health (HH) services on HH payment claims (refer to the factsheet for G-Codes).
Through December 31, 2024: Telehealth can be used for hospice care eligibility recertification, and behavioral or mental telehealth providers are exempt from certain in-person visit requirements.
Extended Program: CMS has extended the Acute Hospital Care at Home Program
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Other Changes to the Telehealth Services Factsheet
The Medicare telehealth 2023 factsheet also contains significant deletions from the previous version, including the following:
Removing the permanent eligible originating site list
Requiring patients to be in rural areas
Permanent distant site provider list.
These updates and deletions likely aim to clarify the current reimbursement policy (effective until December 31, 2024) and the permanent policy (effective from January 1, 2025) and possibly anticipate amendments to the permanent policy before January 1, 2025.
As Medicare telehealth grows in the future, the current update solidifies reimbursement for behavioral and mental health. Providers seeking to grow their telehealth services have ample reason to invest in Medicare telehealth moving forward.
Why Invest in Offering Medicare Telehealth?
Of all the payors consistently funded to expand telehealth in the immediate future, Medicare stands head and shoulders above others. See Telehealth.org’s Growing Your Telehealth Services? Consider Telehealth Medicare Reimbursement for more information. Organizations and clinicians seeking to grow their telehealth service offerings would do well to include Medicare-funded populations in their mix of service offerings.
For comprehensive information on this Medicare telehealth 2023 policy update, refer to the MLN Telehealth Services Factsheet.
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