Prevounce Blog

An Ounce of Prevention

Medicare Waiver Expands Telehealth Service Coverage to All Beneficiaries

Read More
Patient Consulting Telehealth Doctor

Medicare Waiver Expands Telehealth Service Coverage to All Beneficiaries

by Mary Byron

Updated: 5/3/2020

The Centers for Medicare & Medicaid Services (CMS) has announced a significant, temporary broadening of telehealth services coverage.

As of March 6, and for the duration of the novel coronavirus (COVID-19) public health emergency, CMS stated that it will pay for professional Medicare telehealth services furnished to beneficiaries in all areas of the country in all settings. These visits will be considered the same as in-person visits and paid at the same rate as regular, in-person visits. Services covered include the Medicare annual wellness visit (AWV) and Medicare preventive services. These temporary changes are meant to allow providers the opportunity to continue to care for their patients from afar while the threat of coronavirus remains high.

CMS is lifting requirements concerning beneficiaries traveling to originating sites (e.g., physician's office, skilled nursing facility, hospital) for the visit. CMS will pay for Medicare telehealth services furnished to beneficiaries in any healthcare facility or in their home.

While CMS acknowledges that the Medicare coinsurance and deductible would generally apply to these services, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is also providing flexibility for providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.

Finally, CMS noted that to the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during the public health emergency.

On 4/30/20, Medicare further waived restrictions, and now allows Annual Wellness Visits, E/M visits and many preventive services to be conducted via audio-only telehealth (i.e. over the telephone) for the duration of the waiver.

Prevounced was designed to help make performing the annual wellness visit and preventive services easy and efficient both in person as well as via telehealth. As of March 8, we have incorporated all temporary coverage changes into our eligibility system to help guide providers and maximize patient well-being while the crisis waiver is in place. If you would like to see how Prevounce can help your practice adapt to the constantly changing Medicare landscape, schedule a demonstration with us today.

All Posts

Related Posts

Telehealth & Remote Services Update: Medicare Waiver Expansion Impact

Healthcare providers have found themselves under immense pressure to maintain continuity of care during the COVID-19 crisis, but many aspects of the U.S. health system were not designed to support such an effort. To help providers more effectively deliver care that will not only keep patients healthy but also in their homes and away from hospitals, which are largely focused on treating COVID-19 patients, government agencies, commercial payers, and other healthcare organizations have worked to change the system. Approaches taken include the creation of new and expansion of existing telehealth and remote tools and support, including remote patient monitoring (RPM). For example, we have seen federal waivers and revised state regulations that greatly expand the ability for healthcare providers to deliver telehealth and remote services; commercial payers revising their policies to pay for these services, and healthcare companies offering resources to help providers more effectively leverage telehealth and remote services during the crisis. If your practice is considering launching or growing an existing telehealth and/or remote services program during the pandemic, here are five things you should know.

Prevounce Announces New Platform to Simplify Remote Patient Monitoring

Los Angeles, CA – May 4, 2020 – Prevounce Health, creators of the Prevounce Care Coordination Platform, announced today the release of its powerful new Remote Patient Monitoring software and connected patient device program.

Performing Annual Wellness Visits Via Telephone

The annual wellness visit (AWV) is an important tool for providers to track and help manage the health and wellbeing of their Medicare patients. Social distancing is crucial to combat our current health crisis, but so is maintaining continuity of care with your most vulnerable patients. Fortunately, Medicare understands the importance of the AWV, and included it in it's initial §1135 waiver so that it can be performed entirely via telehealth on any Medicare beneficiary. As of 4/30/20, Medicare further waived restrictions, and now allows Annual Wellness Visits to be conducted via audio-only telehealth (i.e. over the telephone) for the duration of the waiver.