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November 17, 2023

CMS Publishes Final Rule [CMS-1784-F] Announcing Finalized Policy Changes for Medicare Payments for Telehealth Services

The Centers for Medicare & Medicaid Services (CMS) released the final regulation on November 2, 2023, that will, among other changes, change (a) the categorization of the codes for telehealth services, and (b) the billing of telehealth services. The final rule will apply to all physicians and clinicians that choose to bill Medicare for telehealth services and will require them to continue billing Medicare using the permanent codes from last year. Although CMS rejected the request to add thirty (30) temporary codes to the list, CMS created a mechanism to add, remove or otherwise change the codes on the list. Additionally, many of those temporary codes will remain until January 1, 2024, and physicians may continue the limited use of the COVID-19 PHE waivers that give physicians the flexibility to provide telehealth services from their home (as opposed to in a health facility or office) until December 31, 2024.  CMS also finalized the policy whereby claims billed under POS 02 (Telehealth Provided Other than in Patient’s Home) will continue to be paid at the lower PFS facility rate and claims billed with POS 10 (Telehealth Provided in Patient’s Home) will be paid at the higher PFS non-facility rate.  CMS anticipates that the telehealth policies introduced in the final rule will allow physicians to continue to properly bill Medicare for telehealth services based on the previous policies while providing a bridge for the new method of billing. The final rule is scheduled to be published in the Federal Register on November 16, 2023.

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