As it pertains to Medicare, the term “telehealth services” refers to a specific set of services that health care practitioners would normally furnish in-person, but for which Medicare covers when they are furnished using interactive, real-time telecommunication technology instead. During the summer of 2019, the Centers for Medicare and Medicaid Services (CMS) issued a new proposed plan which contains these new telehealth services that will be covered under Medicare starting in 2020.
The Social Security Act governs what telehealth services are, and are not, covered under Medicare. The following four statutory conditions are required for Medicare coverage of telehealth services:
1. The patient must reside in a rural area;
2. The services are provided by distant site practitioners who meet all eligibility requirements to provide telehealth services;
3. The beneficiary and distant site practitioner communicate via an interactive audio and video telecommunications system that permits real-time communication between them; and
4. The code for the service rendered is listed on the table of covered Medicare telehealth services.
In 2020, treatment for opioid use disorder will be added as a covered service. Providers should continue to make enhancements to their telehealth programs as the Medicare reimbursements expand into more covered services. This benefits the health care practitioners both from a cost-savings point while also providing more opportunities to generate additional revenue. It also helps patients by being more convenient and saving time and travel costs. For more information on Medicare and other government services that benefit seniors, please contact Stouffer Legal in the Greater Baltimore area.