U.S. Rep. John Katko (R-NY) recently made a bipartisan request that America’s senior citizens have expanded access to Medicare-covered telehealth services.
“Currently, Medicare only reimburses recipients for services conducted with audio and video equipment, excluding coverage of mental healthcare services provided over the phone,” Rep. Katko said on April 9. “With telehealth services being the only way millions of Americans have access to mental health services during the COVID-19 pandemic, it is imperative that CMS [Centers for Medicare and Medicaid Services] immediately acts to expand coverage to audio-only telehealth services, ensuring all Medicare recipients have access to mental healthcare.”
The Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility.
The Centers for Medicare & Medicaid Services is continuing its slow-but-steady move toward Medicare coverage for remote patient monitoring with two changes in the proposed 2020 Physician Fee Schedule that may open the door to more mHealth reimbursement.
On April 5, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates the Medicare Advantage (MA or Part C) and Medicare Prescription Drug Benefit (Part D) programs by promoting innovative plan designs, improved quality, and choices for patients.
CMS just announced a clarification that remote patient monitoring under CPT code 99457 may be furnished by auxiliary personnel, “incident to” the billing practitioner’s professional services. An “incident to” service is one that is performed under the supervision of a physician (broadly defined), and billed to Medicare in the name of the physician, subject to certain requirements, one of which is discussed below. The announcement came in a technical correction issued March 14, 2019 and is effective immediately. This is a highly-anticipated change among remote patient monitoring companies, as we discussed in greater detail in our previous coverage.
Healthcare Law Today
The Centers for Medicare and Medicaid Services has locked in a rule that will allow home health agencies to report the cost of remote patient monitoring for reimbursement under Medicare. According to the announcement, released yesterday, this rule will be implemented in 2020.
Medicare will cover remote-patient monitoring of chronic conditions. Previously, Medicare didn’t pay for separately for such services, requiring that such billing be bundled with an “evaluation and management” code,” according to the ATA.