March 17, 2020

New CMS Telehealth Guidance: What You Need to Know

ACEP staff and some members immediately got on a phone call with CMS leadership to talk about the guidance and what is still missing. We had a great discussion, and we now have an open line of communication with the agency to try to address the remaining gaps.

Summary of the Guidance
  • CMS is waiving all the current geographic and originating site restrictions under Medicare so that telehealth services can take place in both rural and urban areas and from a patients home
  • There is currently a restriction that limits telehealth services from being delivered only to patients who had a pre-existing relationship with the health care practitioner. CMS is now allowing telehealth services to be delivered to new patients.
  • HHS is waiving penalties for HIPAA violations against health care professionals who serve patients in good faith through everyday communications technologies, such as FaceTime or Skype
  •  HHS is allowing physicians to waive beneficiary cost-sharing for telehealth services.

Keep reading below the image to see what we think is missing from the guidance.


What’s missing from this new guidance? 

We had extensive conversation with CMS about what EM physicians still need:
  • EMTALA waiver, so that the medical screening exam can be performed in an alternate location or via telehealth
  • Eliminating licensing and credentialing barriers that impede the ability for providers to provide telehealth services to patients across state lines
    • They are working with states to address this issue.
  •  Allowing health care workers who are quarantined to provide telehealth services since we may be facing a depleting healthcare workforce
  • Adding ED E/M codes to the list of approved Medicare telehealth services
    • CMS claims they do not have the statutory authority to add our codes to the list of billable telehealth services, except through rulemaking.  
Finally, CMS was interested in hearing more about the low supply of PPE.  

We will follow-up with CMS on all these issues and report back once we have more news.
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