CMS expands Medicare emergency telehealth coverage with 11 new services

October 15, 2020

  • CMS said Wednesday it is ​adding 11 new virtual care services for the first time in five months, including cardiac and pulmonary rehab. Since the emergency was declared in March, the agency has added more than 135 new virtual care services to what's covered under fee-for-service Medicare, including ER visits and initial inpatient and nursing facility visits.
  • Use of telehealth has boomed in 2020, especially in the earlier months of the pandemic. Though some were uncertain of how seniors would take to the digital services, Medicare has seen skyrocketing adoption too. Between mid-March and mid-August, more than 12.1 million beneficiaries — more than 36% of people in traditional Medicare — had used a virtual visit, CMS said.

The Trump administration first expanded Medicare to cover telehealth services in March. Then, in a May rule, CMS tweaked the process for adding or removing services from the Medicare telehealth list to allow for faster processing during the COVID-19 public health emergency.

Warning signs that the country's ongoing struggle with the novel coronavirus could worsen in the fall and winter months are intensifying, public health experts say. Across the U.S., more than 30 states reported more COVID-19 cases this past week than the one before, according to Johns Hopkins University data.

The latest expansion brings total covered virtual care services to 144 and was spurred by an executive order President Donald Trump signed in early August, Administrator Seema Verma said in a statement. The order directed his health agencies to work to permanently extend Medicare's broader telehealth coverage, though there's only so much they can do without congressional intervention.

CMS moved to permanently codified Medicare coverage for a handful of telehealth services in its proposed physician payment rule for 2021, though excluded services delivered on an audio-only basis.

It's a notable oversight that could exacerbate existing disparities, some providers said. More than a fourth of Medicare beneficiaries lack access to a computer with high-speed internet or a smartphone with a wireless data plan, making it nigh impossible for them to have a video visit at home.

The 11 telehealth codes added Wednesday include electronic analysis of an implanted neurostimulator pulse generator; non-invasive physiologic studies and procedures; physician services for outpatient cardiac rehab; intensive cardiac rehab, with or without continuous ECG monitoring; and pulmonary rehab, including exercise.

CMS on Tuesday also released a snapshot of how the country's some 91.8 million Medicaid and Children's Health Insurance Program beneficiaries were taking to digitally delivered care. More than 34.5 million services were delivered via telehealth to Medicaid and CHIP beneficiaries between March and June.

That's an increase of 2,632% compared to the same time last year, the agency said.

Use was mostly concentrated in adults aged 19 to 64, followed by children and older adults. It peaked in April for nearly all states and has been declining slowly since May. That jibes with data from other insurance groups, such as the commercially insured population, that virtual care use began to moderate as hospitals and doctor's offices resumed in-person elective procedures and state lockdowns eased.

CMS also released new guidance to state Medicaid directors clarifying some of the agency's telehealth policies and use cases.