AOTA, Along with Coalition Partners, Issues Statement to Fight for Continuation of Medicare Telehealth Services After PHE Ends
This article was updated on May 19, May 15, and May 11 and originally published on May 3.
May 19, 2023
AOTA is pleased to share a successful update on the provision of therapy telehealth services with institutional providers, such as SNFs and other outpatient therapy providers, billing on UB04s. In CMS's updated FAQs on waivers, flexibilities, and the end of the COVID-19 PHE, a new Question #22, addresses policies related to remote services furnished by physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs) in institutional settings after the PHE. The excerpt is pasted below:
"Outpatient therapy services furnished remotely by institutional providers of therapy services such as rehabilitation agencies and comprehensive outpatient rehabilitation facilities, not including those that are receiving payment under any Part A payment systems, should continue to be furnished and billed the same way they have been during the PHE, which can include the use of telecommunications technology and when billed on institutional claims forms...For SNFs and inpatient rehabilitation facilities (IRFs)...To the extent that therapy services furnished via telehealth or telecommunications technology are covered Part A services, then these services would be considered part of the bundled prospective payment system payment under Part A."
While this clarification is a welcome development, CMS has not specified an end date or other time frame for telehealth availability for institutional providers in the FAQs. AOTA, along with its Therapy Coalition partners, will advocate with CMS to seek a clear end date.
More information can be found in the FAQ:
https://www.cms.gov/files/document/frequently-asked-questions-cms-waivers-flexibilities-and-end-covid-19-public-health-emergency.pdf
May 15, 2023
AOTA is excited to share additional updates around OT practitioner provision of therapy services. In an update over the weekend, CMS has confirmed that following the end of the PHE, hospitals may bill for outpatient physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP) services provided to beneficiaries in their homes through telecommunication technology by hospital-employed staff. We still do not have clarification regarding other settings, including SNFs and Rehab Agencies, but we continue to push CMS for an answer.
According to an updated CMS FAQ, "Through the end of CY 2023, PT, OT, SLP...providers should continue to bill for these services when furnished remotely in the same way they have been during the PHE."
More information can be found here (See especially Question #21): https://www.cms.gov/files/document/frequently-asked-questions-cms-waivers-flexibilities-and-end-covid-19-public-health-emergency.pdf
We will use this page to alert practitioners to telehealth PHE advocacy updates per the provisions in the Consolidated Appropriations Act. AOTA is happy to share this good news resulting from the significant advocacy work completed by AOTA and partner organizations.
May 11, 2023
Today marks the official end of the public health emergency (PHE), yet despite persistent advocacy by AOTA and other therapy stakeholders, questions remain about the ability of therapy practitioners to provide telehealth services in outpatient hospital and SNF settings (under Medicare Part B).
In response to this lack of clarity, AOTA joined APTA, ASHA, ADVION (formerly the National Association for the Support of Long Term Care), the National Association of Rehabilitation Providers and Agencies, the American Health Care Association, Alliance for Physical Therapy Quality and Innovation, and APTA Private Practice in issuing the following statement:
Providers and rehabilitation professionals are calling on the Centers for Medicare and Medicaid Services (CMS) to provide clarification of beneficiary access to physical and occupational therapy and speech-language pathology services via telehealth when furnished by institutional providers upon the expiration of the COVID-19 public health emergency (PHE) on May 11th.
Although Section 4113 of the Consolidated Appropriations Act of 2023 (P.L. 117-328) directed CMS to extend the beneficiary access to therapy services furnished via telehealth services initiated during the PHE through the end of 2024, the agency has not provided specific guidance to assure that beneficiaries will continue to have access to these services when furnished by an institutional provider such as a hospital outpatient therapy department, skilled nursing facility, home health agency or outpatient rehabilitation facility.
Read the full Joint Statement.
In late April, AOTA became aware of a concerning Medicare telehealth policy issue that has a significant impact on the provision of telehealth therapy services in facility settings. In brief, CMS was questioning the ability of occupational therapy, physical therapy, and speech-language pathology practitioners to provide telehealth services in outpatient hospital and SNF settings (under Medicare Part B) after the end of the PHE on May 11, 2023. Read the Joint Statement.
AOTA, APTA, and ASHA believed this to be an incorrect interpretation of existing law and policy. Read our joint letter to CMS here. AOTA and the other organizations have also engaged our champions in Congress to urge CMS to provide further clarity, as we believe it was Congress’s intent that all Medicare outpatient therapy services would be allowed to be provided via telehealth through 2024.
The Consolidated Appropriations Act (CAA) of 2023 extended telehealth eligibility for occupational therapy and physical therapy practitioners and speech-language pathologists billing Medicare Part B, i.e., outpatient therapy. However, guidance given by CMS on at least two national provider calls indicates that telehealth services cannot be reported on the UB04 claims form. Discussions and advocacy efforts with AOTA, APTA, and ASHA have now grown into a larger coalition issue, with our skilled nursing facility (SNF) and hospital industry partners joining us in CMS advocacy. The coalition believes that CMS' interpretation of Medicare policy is incorrect and has issued a joint letter to CMS asking that the agency utilize the statutory authority in Sec. 4113 and 4140 of the CAA that currently supports the provision of all outpatient therapy services via telehealth through 2024, regardless of setting.
Stay tuned to the AOTA social media accounts and AOTA website for the most up-to-date Medicare telehealth information, as this is an evolving issue.
This article was originally published on May 3 and was updated on May 11.