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Will CMS Pay for Telehealth After May 11, 2023
Article updated on May 19, 2023!
Disclaimer: This article is current as of May 19, 2023 and if CMS and/or Congress makes any changes, an updated article will be published.
The public health emergency (PHE) ended at the end of the day on May 11, 2023. What providers of outpatient therapy services want to know is will the Centers for Medicare and Medicaid Services (CMS) reimburse for outpatient therapy services delivered via telehealth after May 11, 2023. In this article, I will provide answers to the following questions:
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Rick- thank you for joining the CMS calls. I am shocked that telehealth will not be permitted by CMS for PT/OT/SLP in a hospital-based clinic. I don’t think that was the intent of the APTA advocacy efforts and the subsequent Consolidated Appropriations Act of 2023? Is there a chance this could be reversed- since it was only addressed in an Open Door Forum?
Rick, Can you provide insight regarding CMS’s stance on providing Speech Therapy services virtually for swing bed patients. This would be for a rural Arkansas Critical Access facility.
Thank you
Anthony
That would be a no.
Has there been any clarification/response from CMS regarding telehealth for rehab agencies? Thank you!
The latest information is contained in this article.
Reviewed this article. Also reviewed the CMS attachment. Can you clarify where the information related to hospital claims and the need to submit them on the 1500 versus the UC-04. I was not able to find this detail in CMS information. Our billing office has requested the source.
There is no source. The claim form that you submit is based on how you enrolled your clinic or facility in the Medicare program.
Hi Rick
I am working in a hospital based outpatient rehab dept in MA. Seems like our MAC (National government services) is still saying no to telehealth for us when submitting on a UB-04. Have you heard about this? The quote from their site says. “No, the exception for services provided in a facility that are billed to Medicare Part A on a CMS-1450 (UB-04) expired with the end of the PHE on 5/11/2023. Only therapists billing directly to Medicare Part B on a CMS-1500 (paper or electronic) may continue to bill for these services through 12/31/2024.” This was posted on 6/13.
Read the answer to the 2nd question in this article. It answers your question and gives you the reference.