Medicare Telehealth Services in 2022

Question: Has Medicare’s list of telemedicine for 2022 changed?

Answer: As the Medicare Centers and Medicaid Services (CMS) continue to evaluate the inclusion of telehealth services that were temporarily added to Medicare’s list of telehealth services during the COVID-19 public health emergency, they finalized that some services have been added to Medicare’s telehealth services, the list of services will remain on the list until 31 December 2023.

This will give the CMS extra time to consider whether each service should be permanently added to Medicare’s list of telehealth services.

CMS finalizes that it will extend until the end of CY 2023 the inclusion in Medicare’s list of telehealth services of certain services temporarily added to the list of telehealth services that would otherwise be removed from the list at the end of COVID-19 PHE or December 31, 2021. They also have expanded inclusion of certain codes for cardiac and intensive cardiac rehabilitation by the end of CY 2023. This will give CMS more time to collect data to decide whether each telehealth service will be permanently added. to Medicare’s list of telehealth services.

In addition, the CMS accepts constant encryption and payment for a longer virtual check-in service.

Section 123 of the Consolidated Appropriations Act (CAA) removed geographical restrictions and added the beneficiary’s home as a permitted object of origin for telehealth services provided for the purpose of diagnosing, assessing or treating a mental health disorder. Section 123 requires that these services have a personal, non-health service with the physician or practitioner within six months prior to the initial health service, and a personal, non-health visit must be provided at least every 12 months for these services.

Exceptions to the requirement for a personal visit may be made on the basis of the beneficiary’s circumstances (for the reason documented in the patient’s medical record) and that more frequent visits are also allowed under the policy, depending on clinical needs on a case-by-case basis. . basis of the case.

CMS changed the current definition of an interactive telecommunications system for telehealth services (defined as multimedia communication equipment that includes at least audio and video equipment that allows two-way interactive real-time communication between the patient and the remote physician or practitioner) to include audio-only communication technology when used for telehealth services for the diagnosis, assessment or treatment of mental health disorders provided to identified patients in their homes in certain circumstances.

The CMS restricts the use of an interactive telecommunications system to audio only to mental health services provided by practitioners who have the ability to provide two-way audio / video communications, but when the beneficiary is unable or disagrees, the use of two-way audio / video technology.

CMS also finalizes a requirement to use a new modifier for services provided using audio communications, which would serve to test whether the practitioner had the ability to provide two-way audio / video technology, but instead used only audio technology due to the beneficiary’s choice or limitations. They also clarify that mental health services may include services for the treatment of substance use disorders (SUDs).

The new modifier – Modifier 93 – Synchronous telemedicine service provided by telephone or other interactive telecommunication system for real-time audio only – enters into force on 1 January 2022.

“Synchronous telemedicine service” is defined as a real-time interaction between a doctor or other qualified healthcare professional (QHP) and a patient who is far away from the doctor or other QHP. The set of communication information exchanged between the physician / QHP and the patient during the synchronous telemedicine service must be in a quantity and nature sufficient to meet the key components and / or requirements of the same service when provided through face-to-face interaction.

Renee Dowling is a compliance auditor for Sansum Clinic, LLC, Santa Barbara, California.

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