House Passes Extension of Occupational Therapy Telehealth Waivers Through End of 2024 - Senate Action Still Needed
On July 27, the House of Representatives passed a revised version of HR4040, the Advancing Telehealth Beyond Covid Act, which would continue Medicare telehealth waivers through the end of 2024 regardless of the status of the public health emergency (PHE). The bill was introduced by Rep. Liz Cheney (R-WY), and the Senate must now adopt this legislation for the policy to go into effect. Congress has already enacted legislation this year to provide a 151-day waiver extension beyond the PHE, but most observers believe that the PHE will end long before the end of 2024. If enacted, the newly passed extension would allow occupational therapists and occupational therapy assistants to provide services via telehealth to Medicare beneficiaries for all of 2023 and 2024.
The House bill would enable Congress to review more recent data from CMS and other sources regarding the use of telehealth during years less impacted by the pandemic to enact permanent policy changes. We will continue to work with Congressional champions to ensure that the Centers for Medicare & Medicaid Services (CMS) implements the waiver policy as intended, and that future legislation to address telehealth in Medicare on a permanent basis also includes occupational therapy.
The PHE currently extends through October 13, 2022, although the Department of Health and Human Services (HHS) has indicated that it will announce its intention to let the PHE expire at least 60 days in advance. Extensions are made in 90-day increments.
We will continue to work for passage of the Expanded Telehealth Access Act (H.R. 2168/S.3193) which has attracted 70 House and 7 Senate co-sponsors. That bill would permanently enable occupational therapy practitioners (OTPs) to provide occupational therapy services to Medicare beneficiaries via telehealth. You can ask your Members of Congress to cosponsor this bill through our Legislative Action Center.
Legislation is essential because CMS does not have the authority to allow occupational therapists, occupational therapy assistants, or other therapy providers to provide services via telehealth after the PHE waivers expire, although it has extended some OT telehealth CPT® codes through the end of 2023 regardless of the status of the PHE. Without Congressional action, however, no OTPs would be allowed to bill these codes, so occupational therapy services via telehealth would end for Medicare beneficiaries.
The use of telehealth as appropriate during the pandemic has enabled occupational therapists and occupational therapy assistants to improve efficiency of care by minimizing therapy delays and missed appointments related to travel and access issues and improve outcomes by allowing visual access to a beneficiary’s home environment. Working with individuals virtually in their authentic home environment, occupational therapy practitioners can identify physical safety risks and contextual barriers to daily life performance that may not have been revealed otherwise.
When the pandemic struck, Congress enacted legislation that enabled CMS to waive restrictions on occupational therapy practitioners’ and other therapy providers’ ability to provide Medicare services via telehealth. CMS responded by issuing an emergency rule that added a series of therapy CPT® codes to the telehealth services list, then subsequently issued another rule that included occupational therapy practitioners as eligible Medicare telehealth providers, after Congress enacted legislation allowing them to do so. This effectively enabled occupational therapists and occupational therapy assistants to provide services via telehealth to Part B Medicare beneficiaries during the COVID-19 emergency; however, these waivers are not permanent.
AOTA will continue to work with Congressional champions to ensure that occupational therapy is included when Congress addresses this issue. Contact Andy Bopp, abopp@aota.org, with any questions.