Medicare Telehealth Success
The Centers for Medicare and Medicaid Services (CMS) announced that occupational therapists, physical therapists, and speech language pathologists can now perform telehealth services for Medicare beneficiaries during the COVID-19 Public Health Emergency.
New Waiver Language:
Eligible Practitioners. Pursuant to authority granted under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) that broadens the waiver authority under section 1135 of the Social Security Act, the Secretary has authorized additional telehealth waivers. CMS is waiving the requirements of section 1834(m)(4)(E) of the Act and 42 CFR § 410.78 (b)(2) which specify the types of practitioners that may bill for their services when furnished as Medicare telehealth services from the distant site. The waiver of these requirements expands the types of health care professionals that can furnish distant site telehealth services to include all those that are eligible to bill Medicare for their professional services. This allows health care professionals who were previously ineligible to furnish and bill for Medicare telehealth services, including physical therapists, occupational therapists, speech language pathologists, and others, to receive payment for Medicare telehealth services.
Based on the language in the new blanket waiver, AOTA is immediately seeking clarification regarding whether it extends to occupational therapy assistants, and will be advocating for inclusion. The waiver is retroactive to March 1, 2020 and is effective throughout the public health emergency. Telehealth services can be billed using the list of telehealth approved CPT® codes that CMS issued on March 30, 2020. AOTA will be developing a more in-depth article with billing guidance, listing the available CPT codes.
AOTA has been proactively and tirelessly advocating for this change with the U.S. Department of Health and Human Services (HHS) and CMS through many means, including meetings, the submission of comment letters, and development of a fillable template comment letter for the profession to engage in advocacy directly. On April 6, AOTA, along with APTA and ASHA, met with CMS to discuss the CARES Act waiver authority to expand the list of telehealth eligible professionals and implore CMS to allow OTs, PTs, and SLPs to perform telehealth immediately amid the COVID-19 PHE.
AOTA is analyzing additional Medicare flexibilities in the 1135 waiver. Additional changes include increased payments to telephone services retroactive to March 1. CMS is also allowing physical and occupational therapists to delegate maintenance therapy services to physical and occupational therapy assistants in outpatient settings. AOTA continues to analyze the new waiver and will provide an update on any additional flexibilities. Read the full press release.