Extensions for Medicare Payment of Telehealth Services

Extensions for Medicare Payment of Telehealth Services Posted By:
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The Secretary of the Department of Health and Human Services extended the public health emergency declaration for the opioid crisis on April 1, 2022. Shortly following this, on April 12, 2022, the public health emergency declaration for the COVID-19 pandemic was also extended. In part, these declarations serve to extend payment for telehealth care by the Centers for Medicare & Medicaid Services.

Expansion of telehealth, in both audio and video modalities, has created improved access to care for patients. At the academic medical center where I have been working for years, patient experience surveys widely applaud telehealth services throughout the pandemic; however, some of this feedback is related to the kind of service provided in the telehealth visit. For example, medication management, chronic diseases care, and some episodic care visits work well remotely, while others are better matched to an in-person visit where a detailed physical exam can be completed.

Mental health services are expanding via telehealth; this type of care seems to be well-suited to a virtual platform. When using the video platforms for these visits, patients' affect, mood, and thought processes may be ascertained. It's also easy to implement and deliver psychotherapy, counseling, and substance abuse support services online or via video call. Medication management is easily accomplished in these modes, as well.

Telehealth may be performed as a synchronous (patient and provider online at the same time), asynchronous (imaging or questionnaire data collected online and then sent to provider for evaluation), or in a remote-monitoring capacity (ongoing stream of clinical data to provider; ie, heart rate collected from smart watch). Advantages include easy and convenient access for both patients and providers, especially for those with mobility or transportation issues or who live in rural areas without options for local healthcare offices. Disadvantages include concerns about privacy, technical issues such as internet access and support, and insurance coverage. Additionally, some services cannot be performed remotely, such as lab work and some components of physical exams.

The COVID-19 pandemic forced us to be nimble and explore creative healthcare solutions. Now, telehealth will continue to play a role in healthcare as we move forward—it will be interesting to see how it becomes integrated in routine and emergency healthcare.

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Filed under: Health Policy and Trends , Public Health

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