During the public health emergency, the list of allowable telehealth services covered under Medicare has expanded to include emergency department visits, physical and occupational therapy, and certain other services. What services can Medicare beneficiaries receive through telehealth?īefore the public health emergency, Medicare covered about 100 services that could be administered through telehealth, including office visits, psychotherapy, and preventive health screenings, among other services. (Medicare Advantage plans have flexibility to offer additional telehealth benefits beyond those that are covered by traditional Medicare outside of the public health emergency, as described below). There was also a relatively limited set of services that could be covered by telehealth. There were also restrictions on which providers could be paid to deliver telehealth services (i.e., “distant site” providers). This is because before the pandemic, coverage of telehealth services under Medicare was limited to rural beneficiaries using telehealth at an “originating site,” such as a clinic or doctor’s office, rather than from their own homes. This means, for example, if the public health emergency ends in October 2022, Medicare coverage of telehealth would revert to more limited coverage in March 2023, and most beneficiaries in traditional Medicare would lose access to telehealth coverage for most services, except for mental health services (see below for more information). The Consolidated Appropriations Act of 2022 (CAA of 2022) extended many of the recent expansions of Medicare’s telehealth coverage for roughly 5 months (151 days) after the end of the COVID-19 public health emergency. Because the Biden Administration has not yet provided a 60-day notice that the public health emergency will end, it is likely the PHE will extend beyond July.įigure 1: A Timeline of Major Medicare Coverage Expansions of Telehealth The public health emergency was most recently renewed in April 2022, and the Biden Administration has said that it will provide a 60-day notice before allowing the public health emergency to expire. To make it easier and safer for beneficiaries to seek medical care during the pandemic, in March 2020, the Secretary of the Department of health and Human Services (HHS) waived certain restrictions on Medicare coverage of telehealth services for Medicare beneficiaries during the COVID-19 public health emergency, based on waiver authority included in the Coronavirus Preparedness and Response Supplemental Appropriations Act (and as amended by the CARES Act) (Figure 1). This is due to a broad but time-limited expansion of telehealth coverage in Medicare during the COVID public health emergency.
People with Medicare can now access telehealth services, whether in urban or rural areas, at home or in other settings, using audio-visual or audio-only technologies, and from a wide range of health care providers. Under current law and regulations, Medicare covers a broad scope of services via telehealth without restrictions that were in place prior to the COVID-19 pandemic, but, for the most part, this broader coverage is available only temporarily. What is the current scope of Medicare telehealth coverage and how did it change at the start of the COVID-19 pandemic? These FAQs provide answers to questions about Medicare’s current coverage of telehealth, changes made at the outset of the public health emergency, additional changes adopted by Congress and the Administration, and some of the policy considerations that lie ahead. During the first year of the pandemic, more than 28 million Medicare beneficiaries overall used telehealth services, including almost half (49%) of Medicare Advantage enrollees and nearly 4 in 10 (38%) beneficiaries in traditional Medicare. Between 20, the number of telehealth visits in traditional Medicare increased 63-fold. Prior to the pandemic, telehealth utilization among traditional Medicare beneficiaries was extremely low, with only 0.3% of traditional Medicare beneficiaries enrolled in Part B using telehealth services in 2016.
Telehealth, the provision of health care services to patients from providers who are not at the same location, has experienced a rapid escalation in use during the COVID-19 pandemic, among both privately-insured patients and Medicare beneficiaries.
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