CMS to continue its expansion of telehealth in Medicare

Centers for Medicare and Medicaid Services (CMS) finalized the Calendar Year 2019 (CY19) Medicare Physician Fee Schedule (PFS). This lays out reimbursement rates for physicians and other health professionals providing services to Medicare beneficiaries. This year’s rule takes another exciting step forward for the telehealth world, with new services like virtual check-ins, store-and-forward, and inter-professional consultations all being reimbursed by Medicare.

CMS will lift restrictions on Medicare reimbursement for substance use disorder treatment provided via telehealth.

Provision for virtual check-Ins

CMS has finalized the proposal to allow “virtual check-ins” in Medicare, which are 5 to 10 minutes of medical discussions that will be conducted by a provider via communications technology-based services including real-time phone and video chat conversations.

This service should be provided to an “established patient” who has seen the treating provider within the period of past three years. It may not be related to a service provider within the past seven days nor lead to a service or procedure within the next 24 hours or soonest available appointment.

In other words, CMS wants the virtual check-ins to be quick, virtual visits for one-off medical questions and condition assessments, not a follow-up that leads to an office visit.