CMS finalizes telehealth pay changes: 5 notes

CMS released the 2025 Physician Fee Schedule final rule Nov. 1, including a plan to preserve certain telehealth flexibilities beyond the expiring temporary pandemic-era measures.

Here are the important takeaways:

1. Limited telehealth flexibilities will continue. CMS aims to sustain some essential telehealth flexibilities into 2025. This includes allowing certain practitioners to supervise auxiliary personnel virtually via real-time audio-video technology, supporting flexibility in patient care.

2. Teaching physicians can use virtual presence, for now. CMS is temporarily extending a rule allowing teaching physicians to supervise residents virtually while providing telehealth services. This is a move to support the teaching environment and improve access in academic medical settings.

3. Reinstatement of pre-pandemic telehealth restrictions. Beginning January 1, 2025, unless Congress acts, previous Medicare restrictions will be reinstated for most telehealth services. This includes limitations on service locations (often restricted to rural, medical facilities) and practitioner types eligible for Medicare reimbursement.

4. Behavioral health services exception: Behavioral health remains an exception to the location restrictions. Medicare beneficiaries can continue to receive behavioral health telehealth services at home, which reflects CMS’s recognition of the ongoing need for accessible mental health care.

5. Preparing for potential Congressional action. While CMS is maintaining limited flexibility where possible, the return of most pre-pandemic rules is imminent without legislative intervention. Executives need to stay informed on any potential Congressional actions that could further extend telehealth flexibilities.

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