• Innovation in Action

May 4, 2020

Read the Latest CMS Updates for Physicians During COVID-19


Last week, The Centers for Medicare & Medicaid Services (CMS) issued another round of updates to assist providers during the COVID-19 public health emergency. We compiled a summary of those updates relevant to physician practices for your convenience. Please note that this information is updated as of May 1, 2020.

  1. To help ensure that Medicare beneficiaries have broad access to testing related to COVID-19, a written practitioner’s order is no longer required for the COVID-19 test for Medicare payment purposes. This includes “parking lot” test sites operated by pharmacies and other entities enrolled in Medicare.
  2. Provider-based hospital outpatient departments that relocate office-campus may obtain a temporary exception to be paid under the Outpatient Prospective Payment System (OPPS), rather than the Physician Fee Schedule.
  3. Hospital systems that include rural health clinics can increase their bed capacity without affecting the rural health clinic’s payments.
  4. Telehealth coverage expansions include:
  • For the duration of the public health emergency, additional types of clinical practitioners can furnish Medicare telehealth services. These include doctors, nurse practitioners, physician assistants, physical therapists, occupational therapists, and speech language pathologists. This also includes hospital-based practitioners providing services to hospital outpatients in their homes, such as counseling, educational, and therapy services.
  • Payments for audio-only telephone visits (CPT codes 99441-99443) are increasing to match payments for similar office and outpatient visits, retroactive to March 1, 2020. This will be an increase in payments ranging from $14-$41 to $46 – $110. Further, eligible services for these audio-only visits have been expanded to include behavioral health and patient education services. CMS is also waiving video requirements for certain telephone evaluation and management services to allow for audio-only telehealth. The full list of covered telehealth services, including those available for audio-only, is available here.
  • CMS is continuing to add new telehealth services without requiring the usual regulatory process in order to speed up the addition of covered codes and is considering requests by practitioners.
  • More information about expanded telehealth coverage can be found here.

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