Will Medicare’s COVID-19 telehealth expansion be permanent?

Medicare’s COVID-19 Telehealth Expansion

In March 2020, The Centers for Medicare and Medicaid Services (CMS) temporarily expanded Medicare coverage for telehealth. This expansion allowed more beneficiaries access to a greater variety of virtual health care services, in effort to reduce the need for in-person appointments during the COVID-19 pandemic.

What telehealth services were originally covered by Medicare?

As communications technology develops, Medicare’s coverage of telehealth services has also continued to evolve over the years. However, before the temporary expansion was put in place, Medicare only covered certain telehealth services provided by doctors, nurse practitioners, physician’s assistants, and other specific types of health care professionals. Virtual appointments generally required both video and audio connections.

During the pandemic, CMS determined coverage would be provided for an increased number of telehealth services, more than doubling the previous list of allowable services. Thanks to the expansion, emergency visits, nursing facility visits, home visits, – as well as physical, occupational, and speech therapy services – and more could all be conducted virtually under Medicare. 

The expansion also allowed coverage for audio-only appointments when video conferencing is not easily accessed or readily available. Other additional barriers were waived to ensure care providers would be reimbursed for telehealth services at the same rate they would be for in-person appointments.

Why was telehealth coverage expanded?

These changes ensured that people enrolled in Medicare, many of whom are highly vulnerable to COVID-19, could continue receiving vital health care services without leaving their homes.

Dramatic Increase of Telehealth During the Pandemic

The availability and use of telehealth services grew significantly during the height of the pandemic. A study from the Centers for Disease Control and Prevention reported that “During June 26–November 6, 2020, 30.2% of weekly health center visits occurred via telehealth”.

Virtual healthcare benefits a wide variety of patients. While the expansion was implemented in direct response to COVID-19, patients with limited mobility or chronic conditions – who were among the most frequent users of telehealth services over the pandemic – may find that expanded telehealth services allow them better access to care overall, even outside of the public health crisis.

Will these Medicare telehealth coverage changes be permanent?

One of the factors that will determine whether or not providers will continue to offer increased telehealth services is Medicare coverage.

In May 2021, Rep. Jason Smith (R-MO) and Rep. Josh Gottheimer 9D-NJ) introduced a bill to the House of Representatives that proposes the audio-only appointment allowance of the Medicare telehealth expansion should be made permanent.

“The pandemic has created challenges for everyone, but it’s also shown us that technology can provide safe and dependable communication between patients and their doctors,” Rep. Smith said. “Innovations including telehealth and audio-only capabilities will improve efficiency, reduce costs and increase access to healthcare providers.”

If the pandemic allowances are not made permanent, Medicare beneficiaries – particularly those in rural environments with limited broadband connectivity or those with low income and with limited access to technology – may no longer receive services they have come to rely on during pandemic. If this bill is passed, it may pave the way for additional telehealth expansions.

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