On May 11, 2023, the U.S. COVID-19 public health emergency (PHE) came to an end. While the declaration was largely symbolic, coming more than three years after the PHE was declared, it was still significant from a regulatory perspective in areas including remote patient monitoring (RPM) and telehealth.
The COVID-19 pandemic motivated agencies include the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to pass numerous rules that helped spur substantial adoption and usage of RPM and telehealth as a means of helping patients receive ongoing treatment and support while reducing the risks associated with in-person care. Now with the end of the PHE, some of those rules are ending. However, others have been extended or were made permanent during the PHE.
Read on to get caught up on how the end of the PHE has — or has not — affected these rules.
Changes to Remote Patient Monitoring and Chronic Care Management
The following are PHE-related changes that pertain to remote patient monitoring or chronic care management that have been reverted to their pre-PHE rules with the ending of the public health emergency (effective May 11, 2023).
16-day/2-day RPM requirement
Medicare providers must resume only billing for the supply of a device or devices used for RPM services during a 30-day period when a patient transmits at least 16 days of physiologic data. Note: The "2-day RPM requirement" associated with confirmed cases of COVID-19 is no longer eligible for billing.
RPM for established patients
Clinicians must resume arranging for an initiating visit for patients not seen within the previous year before clinicians can order and provide remote patient monitoring services.
Collection of Part B copays
Medicare providers must resume collecting the 20% Part B copay from patients for telehealth visits.
HIPAA requirements for telehealth platforms
The Office of Civil Rights (OCR) is resuming enforcement of HIPAA requirements for telehealth platforms (both RPM/CCM and telemedicine).
Other Permanent Telehealth Changes to Know About
The following are PHE-related changes to remote patient monitoring and telehealth that have been made permanent.
Expanded access to tele-behavioral health
Medicare patients can receive telehealth services for behavioral health/mental health care in their home, and there are no geographic restrictions for originating site for tele-behavioral health services.
FQHCs and RHCs as distant site provider for tele-behavioral health
Federally qualified health centers (FQHCs) and rural health clinics (RHCs) can serve as a distant site provider for tele-behavioral health services.
Audio-only communication for tele-behavioral health
Tele-behavioral health services can be delivered via audio-only communication platforms.
REHs as eligible originating sites for telehealth
Rural emergency hospitals (REHs) are eligible originating sites for telehealth
General Telehealth Changes To Know
The following are PHE-related changes to telehealth that have been at least temporarily extended past the end of the PHE. We are including their "effective through" dates, which could be further extended should regulators choose to do so.
Expanded access to telehealth
Medicare patients can continue to receive telehealth services in their home, with no geographic restrictions for originating site for non-tele-behavioral health services. (Effective through at least Dec. 31, 2024)
Expanded telehealth providers
Telehealth services can be provided by all eligible Medicare providers. This includes physical therapists, occupational therapists, speech language pathologists, and audiologists. (Effective through at least Dec. 31, 2024)
Expanded list of telehealth services
Medicare providers can continue to provide and bill for those services on the expanded list of telehealth services eligible for reimbursement. (Effective through at least Dec. 31, 2023)
Expanded list of tele-behavioral services
Providers can continue to bill for those behavioral health services added to the expanded list of eligible telehealth services. (Effective through at least Dec. 31, 2024)
In-person tele-behavioral health visit not required
An in-person visit within six months of an initial tele-behavioral health service, and annually thereafter, is not required. (Effective through at least Dec. 31, 2024)
Continued use of audio-only communication for telehealth
Some telehealth (non-tele-behavioral health) services can still be delivered using audio-only communication platforms. (Effective through at least Dec. 31, 2024)
FQHCs and RHCs as distant site provider for telehealth
Federally qualified health centers and rural health clinics can continue to serve as distant site providers for telehealth (non-tele-behavioral health) services. (Effective through at least Dec. 31, 2024)
Telehealth as an "excepted benefit"
Remote patient monitoring and telehealth are no longer permitted to be treated as standalone "excepted benefits" offered by employers to employees (effective May 11, 2023).
What’s Next for Remote Patient Monitoring and Telehealth?
While the end of the PHE provides some clarity to the future of RPM and telehealth, much remains up in the air. We’re hoping to see some of the temporarily extended changes made permanent (good news: advocates are pushing hard for this to occur) and hoping to see changes that further expand access to remote patient monitoring and telehealth.
We’re excited for the future of RPM and telehealth. More providers, payers, and patients are tapping into these valuable services, and we expect to see continued growth in the virtual care space as these services become more widely understood and feasible.
We'll be paying close attention to the upcoming Medicare rules and various pieces of legislation working their way through Congress, looking for any RPM and telehealth news and developments and then sharing what we find and learn on social media. Follow Prevounce on LinkedIn, Twitter, and Facebook to help you stay current.