CMS Expands Telehealth Services and Flexibility for Non-Physician Providers

On Tuesday, December 1, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Physician Fee Schedule (PFS) final rule, confirming an expansion to telehealth coverage and the scope of non-physician providers. The use of telehealth services increased substantially during the COVID-19 public health emergency. Under the final rule, certain telehealth services will be covered when the COVID-19 public health emergency ends. In addition, the rule reduces administrative barriers to non-physician practitioners, allowing them to focus on providing quality healthcare and less on paperwork.

Prior to the COVID-19 pandemic, CMS estimates that 15,000 fee-for-service Medicare beneficiaries received a Medicare telemedicine visit each week. To address the increased need for healthcare services during the COVID-19 pandemic, CMS added 144 Medicare covered telehealth services. CMS estimates that between March and October 2020, 24.5 million beneficiaries and enrollees received a Medicare telemedicine service. Under the final rule, CMS added more than 60 telehealth services that will permanently be covered under Medicare. Although Medicare does not currently have legal authority to cover telehealth services for beneficiaries who are not located in rural areas, or permit telehealth services to be received in the home, these now permanently covered telehealth services will allow beneficiaries in rural areas, to continue to receive high quality health care and have more convenient access to care.

The final rule also seeks to reduce administrative obstacles for non-physician providers. This will increase efficiency, quality of care, and overall improve the healthcare experience for beneficiaries. The PFS final rule will make certain non-physician provider flexibilities that were established during the COVID-19 pandemic permanent so they may continue to provide care without additional Medicare restrictions. CMS finalized three main changes for non-physician practitioners:

Specific non-physician providers, including nurse practitioners and physician assistants, can take on a supervisory role regarding the performance of diagnostic tests. These non-physician practitioners must supervise within the scope of their practice and in accordance with state law, as well as continue any required relationships with supervising or collaborating physicians.
Physical and occupational therapists will now be able to delegate maintenance therapy to therapy assistants. Maintenance therapy is the continuing care after a therapy program has been established for the patient.
Non-physician practitioners who bill Medicare directly, such as speech language pathologists, and physical and occupational therapists, can now continue to review and verify information in the patient’s medical record, that has already been input by other clinical team members. Previously, such non-physician providers had to re-document the information. This will allow non-physician practitioners to supervise new medical services, more flexibility to delegate care, and decrease the likelihood of duplicate information.

For over 35 years, Wachler & Associates has represented healthcare providers and suppliers nationwide in a variety of health law matters, and our attorneys can assist providers and suppliers in understanding new developments in the physician fee schedule. If you or your healthcare entity has any questions pertaining to healthcare compliance, please contact an experienced healthcare attorney at 248-544-0888 or wapc@wachler.com.