COVID-19: HHS Secretary Issues Medicare Telehealth Waivers

On March 13, 2020, President Trump declared a national emergency beginning March 1, 2020, authorizing the Secretary of the U.S. Department of Health and Human Services (HHS) to, among other things, temporarily waive or modify certain requirements of Medicare under Section 1135 of the Social Security Act (“1135 Waiver”).

Accordingly, the Secretary has utilized 1135 Waiver authority to expand payment of telehealth services nationwide. As of March 6, 2020, Medicare will pay for certain Medicare telehealth visits, virtual check-ins and e-visits as follows:

Medicare Telehealth Visits

  • Consist of a visit between a patient and a practitioner who uses an interactive audio and video telecommunications system permitting real-time communication (“audio/video”). Medicare telehealth visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.
  • Practitioners who can furnish and receive payment for covered telehealth services may include physicians, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, clinical social workers, registered dietitians and nutrition professionals.
  • Available to new or existing practice-patient relationships.
  • Services may be billed using 99201-99215, G0425-G0427 or G0406-G0408, as applicable.1

Virtual Check-Ins

  • Consist of brief, patient-initiated communications, including text, image, voice call or audio/video call with a practitioner for a check-in that is not related to a visit within the previous seven (7) days and does not lead to a medical visit in the next 24 hours. The practitioner may respond to the patient’s concern by telephone, audio/video, secure text messaging, e-mail or use of a patient portal. The patient must verbally consent to receive services.
  • Available to practices that have existing relationships with patients.
  • Services may be billed under Healthcare Common Procedure Coding System (HCPCS) code G2012 or HCPCS code G2010, as applicable.

E-Visits

  • Consist of patient-initiated communications with doctors through online patient portals. E-visit communications can occur over a seven (7)-day period. The patient must verbally consent to receive services.
  • Available to practices that have existing relationships with patients.
  • Services may be billed using Current Procedural Terminology (CPT) codes 99421-99423 and HCPCS codes G2061-G2063, as applicable.

To further facilitate the provision of telehealth services, the HHS, Office for Civil Rights will waive enforcement of the Health Insurance Portability and Accountability Act (HIPAA) regulations against health care providers for good-faith use of telehealth services during the COVID-19 nationwide public health emergency. For more information, see our latest Data Security & Privacy Client Alert.

Additional Assistance

For questions regarding Medicare telehealth waivers, please contact William P. Keefer at (716) 847-5488, wkeefer@phillipslytle.com; Michael Borrello at (716) 504-5702, mborrello@phillipslytle.com; a member of the Coronavirus (COVID-19) Response Team; or the Phillips Lytle attorney with whom you have a relationship.

Coronavirus (COVID-19) Response Team
Sharon Prise Azurin sazurin@phillipslytle.com
Kristen M. Birmingham kbirmingham@phillipslytle.com
Glenn J. Bobeck gbobeck@phillipslytle.com
Michael Borrello mborrello@phillipslytle.com
Craig R. Bucki cbucki@phillipslytle.com
Joanna J. Chen jchen@phillipslytle.com
William D. Christ wchrist@phillipslytle.com
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William P. Keefer wkeefer@phillipslytle.com
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  1. See CMS.gov for the List of Telehealth Services (Last Updated: 11/20/2019 11:26 AM), https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes