The following is an email from the US Pain Foundation dated yesterday, March 21:
Since access and coverage of telehealth has been a wonderful and safe convenience for people with chronic pain during the pandemic, we have been closely following government policy around telehealth coverage and want to update you on recent developments.
Last week, President Biden signed into law HR 2471, the Consolidated Appropriations Act of 2022 which finalized the fiscal year 2022 federal budget and included a number of provisions to extend Medicare telehealth coverage implemented as part of the government’s response to COVID-19. The COVID-19 Public Health Emergency (PHE) has not yet officially ended but is expected to end sometime in the next few months. HR 2471 will extend Medicare telehealth coverage for 151 days or approximately five months after the PHE ends. These extensions include the following:
- Patients’ Location – Medicare beneficiaries can continue to receive coverage for telehealth services from wherever they are located within the U.S., including their homes. Before the PHE, telehealth coverage was restricted to beneficiaries being located in hospitals and certain provider locations in order to receive coverage for telehealth.
- Eligible Practitioners – Medicare beneficiaries can continue to receive coverage for telehealth services from physical therapists and occupational therapists.
- Mental Health Coverage – Medicare beneficiaries can continue to receive coverage for telehealth services from mental health providers without the requirement of an in-person visit within six months of the first telehealth service with that provider nor the requirement of an in-person visit every 12 months.
- Audio-only Telehealth – Medicare beneficiaries can continue to receive coverage for telehealth services using audio-only technology.
This is great news for Medicare beneficiaries! However, although Medicare coverage policies tend to be a bellwether for changes in private payer and Medicaid coverage, please keep in mind that private payer and Medicaid coverage for telehealth services varies by state.
Forty-three states and the District of Columbia (DC) have laws that govern private payer reimbursement of telehealth but what specific services and providers are covered varies greatly. And, while all 50 states and DC now reimburse for some types of telehealth services in Medicaid, many of the reimbursement policies have restrictions and limitations. It is important to check with your state Medicaid program or private insurer to find out what telehealth services are covered.
You can learn more about the efforts that the US Pain Foundation takes around advocacy – including ways to get involved – here.