Expanded Telehealth CoverageThe Centers for Medicare and Medicaid Services (CMS) is once again announced expanded telehealth coverage to assist with the pandemic. On October 14th, CMS announced that it is adding 11 new reimbursable services to the approved telehealth services list, bringing the total of reimbursable telehealth coverage services up to 144, since the beginning of the pandemic. In her statement, Seema Verma, CMS Administrator said, “Medicaid patients should not be forgotten, and today’s announcement promotes telehealth for them as well. This revolutionary method of improving access to care is transforming healthcare delivery in America.” The CMS announcement also stated:

Since the beginning of the PHE, CMS has added over 135 services to the Medicare telehealth services list – such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services. With today’s action, Medicare will pay for 144 services performed via telehealth. Between mid-March and mid-August 2020, over 12.1 million Medicare beneficiaries – over 36 percent – of people with Medicare Fee-For-Service have received a telemedicine service.

CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand telehealth coverage and access to telehealth. The actions reinforce the Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care.

State Medicaid & CHIP Program Toolkit

To further support telehealth, CMS has released a new supplement to its State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version to provide additional examples and insights into lessons learned from states that have implemented telehealth changes. The updated supplemental information is intended to help states strategically think through how they explain and clarify to providers and other stakeholders which policies are temporary or permanent. It also helps states identify services that can be accessed through telehealth, which providers may deliver those services, the means providers may use in order to deliver services through telehealth, as well as the circumstances under which telehealth can be reimbursed once the PHE expires.

The toolkit includes approaches and tools states can use to communicate with providers on utilizing telehealth for patient care. It updates and consolidates in one place the Frequently Asked Questions (FAQs) and resources for states to consider as they begin planning beyond the temporary flexibilities provided in response to the pandemic. To review the Medicaid and CHIP data snapshot on telehealth utilization during the public health emergency, visit this page.

See these TBHI pages for details of previous COVID-related reimbursement information.

Demographics of Telehealth Users as Use Skyrockets

CMS also released a Medicaid and CHIP data snapshot reflecting telehealth utilization by Medicaid and CHIP beneficiaries. It shows the amount of utilization of telehealth services in different states and demographics as well as the increased use by Medicare beneficiaries. The snapshot revealed that telehealth service usage has been highest among working-age adults, followed by services for children and then older adults. Usage varied across states in all categories.  Over 34.5 million services were delivered to Medicaid and CHIP beneficiaries from March through June 2020. Usage by Medicare beneficiaries has swelled since the pandemic began with over 36% of all Medicare beneficiaries (over 12.1 million people), utilizing telehealth from mid-March through mid-August 2020.

The need for telehealth services during the pandemic has stimulated dramatic reform in the delivery of health care services. Both Medicare and Medicaid beneficiaries now have growing access to and are utilizing care via telehealth; care which they would not have been able to benefit from without the sweeping reforms that have been taking place due to the pandemic.