COVID-19: CMS throws open door to telehealth

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Crystal Yednak Senior Manager, Health Research Institute, PwC US March 20, 2020

Providers—from doctors to nurse practitioners to PAs—can bill CMS same as in-person visits.

Telehealth companies hoping to help during the COVID-19 pandemic got a boost this week as CMS announced new measures to expand coverage for Medicare beneficiaries. CMS also emphasized that states can cover telehealth for Medicaid beneficiaries.

“These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus,” said CMS Administrator Seema Verma in a statement. “Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.” Medicare previously restricted when it would pay for telehealth, such as for beneficiaries living in a rural area.

The new policy states that, as of March 6, CMS will temporarily pay clinicians for telehealth services, including office visits, mental health counseling and health screenings, for Medicare beneficiaries. Medicare coinsurance and deductible will still be in effect, but HHS also is offering providers the option of reducing or waiving cost sharing for telehealth services provided to Medicare beneficiaries.

HRI impact analysis

The changes come as the nation braces for a wave of COVID-19 patients that threatens to overwhelm the nation’s healthcare providers. HRI, in its new report, identified telehealth as an important tool to keep vulnerable populations connected to providers while staying home and also for keeping patients who do not need hospital care home.

Telehealth for elderly Medicare beneficiaries can help to reduce their exposure to the virus, which has proven especially deadly to this population. Providers should prepare for expanded capacity of virtual health options and could find telehealth a way to protect some of their clinical staff who have chronic conditions or are elderly.

Telehealth providers may find it hard to keep up. This week, there were reports of companies finding it hard to meet demand as Americans turned to virtual care.

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Contact us

Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Crystal Yednak

Senior Manager, Health Research Institute, PwC US

Erin McCallister

Senior Manager, Health Research Institute, PwC US

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