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Medicare’s Post-Pandemic Telehealth Benefits

During the COVID-19 pandemic, the country quickly adapted to telehealth medicine. Telehealth medicine became essential, as it ensured people could maintain non-emergent medical services during the pandemic. To protect providers and patients and encourage social distancing, The Centers for Medicare & Medicaid Services (CMS) temporarily allowed telehealth Medicare services that were not allowed previously.

How COVID-19 Led to Temporary Expanded Medicare Benefits

Before the pandemic, virtual appointments were only available to patients in rural or remote areas, which only included about 20% of Medicare beneficiaries. Additionally, most patients would have to go to an “originating site” at a healthcare facility to use this service.

During the pandemic, all Medicare beneficiaries gained at-home access to telehealth services. This eliminated the requirement to drive to an originating site and lifted the limitations set by geographical locations. Additionally, an existing patient-provider relationship was no longer required to receive virtual services.

Americans seamlessly transitioned from in-person to virtual medical services in most fields. As time passed, the benefits of telehealth became more apparent as it was comfortable, convenient, and flexible for both patients and providers. However, Medicare beneficiaries who benefited from telehealth services became concerned about the availability once the federal public health emergency (PHE) order ended.

The Permanent Expansion of Benefits

The PHE was projected to end on October 13, 2022. However, the 2022 Consolidated Appropriations Act extended the expanded Medicare telehealth coverage for 151 days beyond the end of the PHE. This allows for an adjustment period for those no longer receiving coverage. Fortunately, Medicare has announced that some telehealth coverage will be expanded permanently.

Here is what you need to know about Medicare’s permanent expansion of telehealth benefits.

  • Many services added during the COVID-19 pandemic will be on the fee schedule permanently.
  • Medicare beneficiaries can now receive telehealth care for mental and behavioral health, including audio-only services, at home under certain conditions.
  • Video-based mental health visits for Rural Health Clinics and Federally Qualified Health Centers will be covered permanently.
  • The expanded list of telehealth providers will only be covered through the 151-day PHE extension period.
  • The in-home flexibility, as opposed to the originating site requirement, will end after the 151-day PHE extension period.
  • Once the 151-day extension period concludes, so will coverage for audio-only telehealth services.
  • After the 151-day extension period is over, mental health telehealth services coverage will require an in-person visit within six months of the first assessment and every 12 months after, like before.

Before the COVID-19 pandemic, telehealth services covered by Medicare were very limited. After the federal Public Health Emergency was made effective in January 2020, 144 Medicare services were added to the list of telehealth coverage. While many Americans have adapted to the convenience and comfort of telehealth, many of these policies will end once the PHE extension concludes. However, the CMS will likely expand the program upon more research.

Our office strives to offer valuable information that could impact our clients. Our elder law attorneys are continually focused on making it easier for seniors to improve their health and quality of life. If you have questions or would like to discuss your personal legal matters, with a Florida Elder Law Attorney please don’t hesitate to contact us at (321) 729-0087.

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