CMS Archives - National Consortium of Telehealth Research Centers

CMS Drops 2019 Telehealth Fact Sheet for Medicare

By | National Telehealth Policy Resource Center Blog

The Center for Medicare & Medicaid Services (CMS) recently released its 2019 Medicare Fact Sheet for Telehealth Services which outlines what services the program will reimburse if delivered via telehealth.  The 2019 Fact Sheet outlines the changes that were made by two pieces of legislation passed in 2018, the Bipartisan Budget Act of 2018 (BBA) and the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (Support Act).  Both Acts expanded where services delivered via telehealth could take place.
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North Dakota Advances Bill that Allows for Valid Relationship Over Store-and-Forward Telemedicine

By | National Telehealth Policy Resource Center Blog

In North Dakota’s SB 2094, which was introduced in early January and amended in the Senate Human Services Committee later that month, has been gaining some attention in telehealth circles due to some of its more unique characteristics; largely because it allows a valid relationship between a licensee and a patient to be established over telemedicine.  Alone this is not unique, as it is relatively common for states to allow a licensee-patient relationship to be established via live video telemedicine (CCHP has identified at least 28 states with this explicit allowance).  However, the legislation specifies that the examination can take place either via video conferencing or “store-and-forward technology for appropriate diagnostic testing and use of peripherals.”  It goes on to specify that in certain types of telemedicine utilizing asynchronous store-and-forward technology or electronic monitoring, such as teleradiology or intensive care unit monitoring, it is not necessary to conduct an independent exam of the patient.  This allowance for store-and-forward to be used in establishing a valid relationship is rare.
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CMS Begins Virtual Communication Reimbursement as States Take Different Approaches to Telehealth Policy

By | National Telehealth Policy Resource Center Blog
CMS Releases Virtual Communication FAQs & MLN Matters Guidance for RHCs and FQHCs
Beginning January 2019, the Centers for Medicare and Medicaid Services (CMS) began reimbursing for certain kinds of services furnished remotely using communications technology that are not considered “Medicare telehealth services.” Because they are not defined specifically as telehealth, the limitations and restrictions generally applicable to telehealth in Medicare do not apply.  These services include “virtual communication services” including communication technology-based services (HCPCS code G2012) and remote evaluation services (HCPCS code G2010).  However, due to the unique rules that apply to federally qualified health centers (FQHCs) and rural health clinics (RHCs), CMS has assigned a new code (G0071) specifically for these safety-net clinics to utilize for virtual communication services as they are not eligible to bill G2010 or G2012.  As a result of this policy change, CMS has released an FAQ document on the topic to help clarify any confusion around the use of the new code for FQHCs and RHCs.  View the FAQs for the full scope of the questions and concerns answered through the document.

Additionally, a Medicare Learning Network (MLN) Matters document was also released with instructions for FQHCs and RHCs billing Medicare Administrative Contractors (MACs) for communication technology-based services.  The document stipulates that the payment rate for G0071 is set at the average of the Physician Fee Schedule (PFS) non-facility payment rate for communication technology-based services and remote evaluation services, and that the face-to-face requirement that normally applies to RHCs and FQHCs is waived for these services.  For more information on the requirements, see the full MLN Mattersdocument.

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National Consortium Webinar – CCHP Presents: Federal and State Policy Updates for CY 2019, including CMS Changes & State Level Trends

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Join the Center for Connected Health Policy (CCHP) on November 28, 2018 at 12 pm PT for an examination of recent telehealth policy changes.  CCHP Executive Director, Mei Kwong, and Policy Associate, Christine Calouro will be joined by Jonathan Neufeld, PhD of gpTRAC to talk about:


  • CY 2019 Medicare Telehealth Policy Changes
  • Medicare Advantage Plans & Telehealth
  • Latest on Telehealth & Substance Use Disorder
  • Developments on the State Level
  • FQHCs & RHCs

Space is limited for this free webinar, reserve your spot today.

This webinar is being sponsored by the National Consortium of Telehealth Resource Centers.

Download the Powerpoint  


By | National Telehealth Policy Resource Center Blog

CMS Proposes Changes to Medicaid Network Adequacy Standards

In a proposal released on Nov. 8, 2018, CMS proposed changes to regulations on network adequacy standards. The changes would allow states to elect alternative quantitative standards to measure network adequacy, including but not limited to, minimum provider-to-enrollee ratios; maximum travel time or distance to providers, maximum wait times for an appointment, and other quantitative standards. Currently, regulations require states to establish network adequacy standards by developing and enforcing time and distance requirements for specified specialty providers. States have commented that these measurements are sometimes inaccurate, especially in locations where telehealth services are heavily used, where a provider-to-enrollee ratio provides a more accurate representation of access.
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By | National Telehealth Policy Resource Center Blog

Last week CMS released its finalized Calendar Year (CY) 2019 Physician Fee Schedule containing momentous changes for Medicare, aiming to modernize the healthcare system and help “restore the doctor-patient relationship” by reducing administrative burden. Among the changes, the proposed rule not only expands telehealth reimbursement, but communicates a new interpretation by CMS of the applicability of their statutory requirements for reimbursement of telehealth. Telehealth-delivered services under Medicare is limited in statute by 1834(m) of the Social Security Act which limits the use of telehealth to certain services, providers, technology (mainly live video) and patient locations (needing to be in certain types of healthcare facilities in rural areas). CMS, in their rule, expresses concern that these requirements may be limiting the coding for new kinds of services that utilize communication technology.

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CMS Proposes Telehealth Expansion for Medicare Advantage Plans

By | Recent Telehealth News

Article Author: Eric Wicklund

Source: mHealth Intelligence

The Centers for Medicare & Medicaid Services is looking to expand telehealth access for members enrolled in Medicare Advantage plans.

As part of a 362-page proposal issued on October 26, the Centers for Medicare & Medicaid Services (CMS) is proposing to eliminate geographical restrictions on telehealth access in MA plans by 2020, enabling those in urban areas to use connected health technology. The proposal would also give members more locations to access care, including their own home.

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