Medicare Eligibility Phone Number Providers – Telehealth, the delivery of healthcare services to patients from non-central providers, has seen rapid growth among privately insured patients and Medicare beneficiaries during the Covid-19 pandemic. Before the pandemic, telehealth use among traditional Medicare beneficiaries was low, with only 0.3% of traditional Medicare beneficiaries enrolled in Part B using telehealth services in 2016. Between 2019 and 2020 , the number of telehealth visits in traditional Medicare increased by 63. . During the first year of the pandemic, more than 28 million Medicare beneficiaries used telehealth services overall, including nearly half (49%) of Medicare Advantage enrollees and nearly 4 in 10 (38%) Medicare beneficiaries traditional

These FAQs provide answers to questions about current Medicare health insurance coverage, changes made in response to public health emergencies, other changes Congress and the administration have adopted, and some ongoing policy initiatives.

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What is the current scope of Medicare telehealth coverage and how has it changed with the onset of the COVID-19 pandemic?

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Under current laws and regulations, Medicare covers many services through telehealth without the restrictions that existed before the COVID-19 pandemic, but for the most part, this expanded coverage is only temporary. People with Medicare can now access telehealth services whether in rural or urban areas, at home or in other settings, using audio-visual or audio-only technology, and through many health care providers. This is due to the broad but long-term expansion of telehealth coverage in Medicare during the public health emergency of Covid. To make it easier and safer for beneficiaries to access health care during this pandemic, in March 2020, the Secretary of the Department of Health and Human Services (HHS) removed some restrictions on Medicare coverage of telehealth services to to those who -Medicare benefits during COVID-19. -19. Pursuant to the waiver authority contained in the Public Health Emergency Preparedness and Response Supplemental Act (and amended by the CARES Act) (Figure 1). The public health emergency was recently renewed until April 2022, and the Biden administration has said it will give 60 days notice before the public health emergency ends. Because the Biden administration has not given 60 days notice that the public health emergency will end, PHE is likely to extend beyond July.

The proposed Act of 2022 (CAA of 2022) extends many of the recent expansions of Medicare telehealth coverage for approximately 5 months (151 days) after the end of the public health emergency COVID-19. This means, for example, that if the public health emergency ends in October 2022, Medicare telehealth coverage will revert to limited coverage in March 2023, and most traditional Medicare beneficiaries will receive telehealth for many services , except for mental health. to cover. Services (see below for more information). That’s because before the pandemic, coverage of telehealth services under Medicare was limited to rural beneficiaries who used telehealth at a “primary site,” such as a hospital or home, the doctor’s work, rather than to do it at home. There are also restrictions on what providers can charge for providing telehealth services (ie, “remote site” providers). There is also a limited range of services that telehealth can cover. (Medicare Advantage plans have changes to offer more telehealth benefits than traditional Medicare coverage outside of public health emergencies, as explained below.)

Before the public health emergency, Medicare covered about 100 services that could be performed through telehealth, including office visits, psychotherapy and preventive health screenings, among other services. During public health emergencies, the list of telehealth services covered by Medicare is expanded to include emergency department visits, physical and occupational therapy, and certain other services. Some patients may be offered assessment and management, behavioral health, and patient education services via audio-only telephone.

In the 2022 physician budget final rule, the Centers for Medicare and Medicaid Services (CMS) extended funding for small telehealth services through December 31, 2023 (or the end of the year in which public health emergency). Do not pull the cover. , each later) to give both CMS and beneficiaries time to evaluate whether they will be permanently included as Medicare-covered health care services. These services include physical and occupational therapy, end-stage renal disease (ESRD) visits, emergency department visits, palliative care services, and more.

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During the Covid-19 pandemic, telehealth has played an important role in accessing mental health services for adults, one in four of whom reported anxiety or depression in August 2020. During the first year of the epidemic, the vast majority of behavioral health services for Medicare beneficiaries were managed through telehealth, and more behavioral health services for traditional Medicare beneficiaries (16%) than for enrollees to Medicare Advantage (9%). Telehealth played its role.

Under provisions of the Mental Health Contracts Act of 2021, policymakers have expanded coverage of telehealth services to detect, diagnose, or treat mental health problems after the emergency ends of public health COVID-19. . Medicare beneficiaries can use telehealth for mental health services in their homes, and beneficiaries who cannot use real-time two-way audio and video for telehealth mental health services can access services that only audio devices are allowed. Beneficiaries must receive face-to-face, non-telehealth services within six months of their first mental health service (although the 2022 CAA repealed the requirement for 151 days after the end of the public health emergency) .

Cost-effectiveness sharing of telehealth services during public health emergencies is not consistent. Medicare covers telehealth services in Part B, so traditional Medicare beneficiaries who use these benefits will be able to deduct $233 in Part B at a 20% discount in 2022. However, the Office of Inspector General of HHS has issued that providers have made changes to reduce or eliminate premiums. for telehealth visits during the public health emergency COVID-19, although there is no public data available to show that providers have done so. . Many traditional Medicare beneficiaries have supplemental insurance that may pay some or all of the cost of covered telephone services. Medicare Advantage plans have the flexibility to change cost-sharing requirements if they meet equity and other CMS requirements.

During the public health emergency of COVID-19, Medicare-covered telehealth services may be conducted through an interactive video conferencing system, using cordless phones with audio/video capability. In addition, a limited number of telephone services may be provided to patients via an audio-only or non-video telephone (such as telephone assessment and management services and behavioral health counseling).

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After a period of 151 days from the end of a public health emergency, telehealth visits must be conducted using two-way audio/video communication; Audio-only telephones will not be permitted except for mental health services (as described above).

During a public health emergency, any health care professional is eligible to pay Medicare for services the professional can provide and to pay for telehealth services without first treating the beneficiary. In addition, eligible federal health agencies and eligible community health clinics are eligible for reimbursement for telehealth services provided to Medicare beneficiaries during the public health emergency of COVID-19; These foundations were not licensed as providers of telehealth services for Medicare beneficiaries before the changes in laws and regulations that occurred at the start of the pandemic.

If no other changes are made to the law, 151 days after the end of a public health emergency, Medicare reimbursement for telehealth will revert to the previous public health emergency law. Under these laws, only physicians and certain other professionals (such as physician assistants, social workers, and psychologists) are eligible to receive Medicare payments for telehealth services provided to traditional Medicare beneficiaries, and they will receive what the beneficiary should have. was treated Work in the last three years

During a public health emergency, Medicare pays for telehealth services, including those provided by telephone with audio only, as if they were administered in person, with payment rates that vary by provider state and the state. , meaning Medicare pays more for the group. A physician provides telehealth services in a nonworkplace setting, such as a doctor’s office, through a physician in a facility, such as an outpatient service. It also means that during a public health emergency, physicians in homeless settings receive higher fees for telehealth services provided than before the public health emergency.

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Assuming no changes to current law, Medicare payments for telehealth services after the 151 period following the end of a public health emergency will be the same whether provided in a non-residential setting or in a facilities environment, and the debt of the payment rates. it will depend on the small amount that is paid to the suppliers for the services provided in person. (Under Medicare’s physician fee system, payments to institutional providers for individual services are lower than payments to noninstitutional providers because Medicare pays the variety to the company to cover the practice.

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