Congress Extends Occupational Therapy Telehealth Waivers for 151 Days Beyond Expiration of PHE

On March 10, Congress passed the Consolidated Appropriations Act for fiscal year 2022, which includes an extension of current Medicare telehealth waivers for 151 days beyond the expiration of the public health emergency (PHE). This includes a specific extension for occupational therapists and occupational therapy assistants to provide services via telehealth to Medicare beneficiaries. 

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 beyond this waiver period also includes occupational therapy. The newly adopted provisions will prevent an OT “telehealth cliff” in Medicare when the PHE expires, while also enabling Congress to review further data from CMS and other sources regarding the use of telehealth to enact permanent policy changes.

The PHE currently extends through April 16, 2022, although the Department of Health and Human Services (HHS) has indicated that it would announce its intention to let the PHE expire at least 60 days in advance. Many now expect the PHE to be extended through July, although extension beyond that is uncertain given the course of the pandemic. 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 64 House and 5 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.