Congress to pass extension of occupational therapy telehealth waivers through end of 2024
Among multiple provisions impacting occupational therapy in the Omnibus Reconciliation Act, Congress extended Medicare telehealth waivers through the end of 2024. This extension will occur regardless of the status of the ongoing public health emergency (PHE) and will allow occupational therapists and occupational therapy assistants to provide services via telehealth to Medicare beneficiaries for all of 2023 and 2024. The Omnibus Reconciliation Act includes multiple legislative policies and will keep the government funded for the next fiscal year.
The extension enables Congress and the Centers for Medicare & Medicaid Services (CMS) to gather and analyze more data regarding the use of telehealth in Medicare while establishing permanent telehealth policy. The Government Accountability Office (GAO) has already issued a report that highlights the need for enhanced data collection and further analysis of telehealth usage by CMS, and the Medicare Payment Advisory Commission (MedPAC) plans to issue an analysis of telehealth usage by June 2023 as required by Congress.
Occupational therapy represents only a small fraction of the services provided via telehealth in Medicare. Congress, however, must still act to allow occupational therapy practitioners (OTPs) to utilize telehealth on a permanent basis beyond 2024 since CMS does not have the authority to do so on its own. CMS has already extended some OT telehealth CPT® codes through the end of 2023 regardless of the status of the PHE, and the latest waiver extension ensures that OTPs can provide these services and bill these codes.
The use of telehealth during the pandemic has enabled OTPs to improve efficiency of care by minimizing therapy delays and missed appointments related to travel and access issues while improving outcomes by allowing visual access to a beneficiary’s home environment. Working virtually with individuals in their authentic home environment, OTPs can identify physical safety risks and contextual barriers to daily life performance that may not have been revealed otherwise. OTPs report that these enhanced care options via telehealth would remain of great benefit to patients even in the absence of a pandemic or health emergency.
When the pandemic first struck, Congress enacted legislation that enabled CMS to waive restrictions on OTPs’ and other therapy providers’ ability to provide Medicare services via telehealth. CMS responded by issuing emergency rules that added a series of therapy CPT® codes to the telehealth services list and included OTPs as eligible Medicare telehealth providers. Later, Congress passed legislation to extend the majority of telehealth waivers until 151 days after the PHE formally expires, anticipated to be at some point in 2023. The legislation included in the Omnibus was originally passed by the House in July.
Advocacy by AOTA and other therapy groups ensured the inclusion of therapy providers in each of these extensions. We will continue to advocate for legislation to permanently allow OTPs and other therapists to provide services via telehealth in Medicare. This will include support for reintroduction of the Expanded Telehealth Access Act which attracted 71 House and 7 Senate co-sponsors in the current Congress. This bill would permanently enable OTPs to provide occupational therapy services to Medicare beneficiaries via telehealth. Contact Andy Bopp, abopp@aota.org with any questions.