Following Push from Rep. Axne, CMS Announces Expansion and Clarification of Telehealth Services for Iowans

May 5, 2020
Press Release
New rules released by the Centers for Medicare and Medicaid Services, which clear up long-standing confusion for telehealth providers and expand therapy services, reflect provisions of Rep. Axne’s bipartisan legislation

Today, Rep. Cindy Axne (IA-03) applauded new rules from the Centers for Medicare and Medicaid Services (CMS) that expand telehealth access for four key therapeutic services and ensure telehealth providers can be paid fairly for their services during this coronavirus (COVID-19) outbreak.

Prior to the announcement, CMS had not permitted physical therapists, occupational therapists, speech pathologists, or audiologists to utilize telehealth for their patients.

Last month, Rep. Axne introduced bipartisan legislation to ensure those same therapeutic services and those provided by clinical social workers are covered under CMS telehealth reimbursement rates.

“It is common sense to let folks access these critical therapies online, and I’m glad to see CMS is finally allowing telehealth in these areas,” said Rep. Axne. “I hope that these services will get up and running quickly to ensure vulnerable Iowans don’t need to risk unnecessary travel in order to keep receiving their care. In addition, there are still services that need a telehealth option, and I’ll continuing fighting to expand virtual options for health care during this outbreak.”

The new CMS rule directives aim to better connect health platforms to patients online, and are only in force for the duration of the COVID-19 public health emergency. Some key changes include:

  • Allowing physical and occupational therapists and speech language pathologists to receive Medicare reimbursement rates for telehealth services provided.
  • Hospitals can now bill for outpatient services furnished remotely by hospital-based practitioners, including telehealth to patients at home – considered a “temporary provider-based department of the hospital.” They can now bill Medicare as the originating site for telehealth services furnished to those patients.
  • CMS is expanding the list of audio-only phone services reimbursable through Medicare to include many behavioral health and patient education services, and the agency is increasing reimbursements for those services to match similar office or outpatient services, retroactive to March 1.
  • Federally Qualified Health Centers and Rural Health Clinics will now be reimbursed for providing telehealth services.
  • CMS is waiving the video requirement for certain evaluation and management services, enabling providers to bill Medicare for services delivered by audio-only platforms.

In March, Congress unanimously passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which included language that gave the CMS Administrator authority to expand telehealth usage. While CMS has provided telehealth billing codes for these services, usage of them had not been authorized prior to recent announcement, leading to confusion among patients. Rep. Axne’s legislation would codify the authority for these services to be accessed through telehealth to better meet patients’ needs.

Rep. Axne’s bill has been endorsed by nearly two dozen health care and patient advocacy organizations, including the American Hospital Association, the ALS Association, American Telemedicine Association, National Association of Community Health Centers, American Physical Therapy Association, American Occupational Therapist Association, American Academy of Audiology, Academy of Doctors of Audiology, American Speech-Language-Hearing Association, National Council on Aging, Alliance for Physical Therapy Quality and Innovation, American Cochlear Implant Alliance, Iowa Physical Therapy Association, Iowa Occupational Therapy Association, Des Moines University, Briar Cliff University, and Millennium Rehab and Consulting, and others. 

“Exposure to COVID-19 would be catastrophic for someone living with ALS,” said Neil Thakur, Ph.D., Chief Mission Officer at The ALS Association. “Robust telehealth options solve many concerns for people with health vulnerabilities who should not leave home during this crisis. We support this important legislation that would expand access to audiology and social services, which are critically important to people living with ALS.”

“Leveraging the power of telehealth to ensure access to critical health services, including managing debilitating illnesses and providing needed care for vulnerable patients, is an important step to make certain they do not forego the care they need during the pandemic,” said Ann Mond Johnson, CEO of the American Telemedicine Association. “We commend Rep. Axne, Rep. Balderson, and Rep. Hill for their continued leadership and effort to extend necessary health care services to beneficiaries during this unprecedented public health emergency.”

The benefits of therapy services include improved health and quality of living and reduced return visits to health care providers. One to two weeks of weekly physical therapy sessions can help lower the likelihood of re-hospitalization for older adults by up to 82% in a 60-day period, according to a 2019 study published in the Journal of the American Medical Directors Association.

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Issues: 
Health Care