Final Physician Rule Changes Supervision, Adds Telehealth Codes, Some Permanently

In the 2021 final Medicare Physician Fee Schedule (MPFS) rule,[1] CMS made both permanent and temporary changes to supervision, telehealth and other provisions, capturing the fluidity of COVID-19 pandemic times. The rule, which was announced Dec. 1, extended the shelf life of some additions and revisions, which won’t expire until the end of the year in which the public health emergency (PHE) is over, presumably Dec. 31, 2021.

That gives providers more room to breathe, but it complicates compliance as they track the end dates of new services and other flexibilities. “Providers are going to have to sort through what’s permanent, what’s temporary for the duration of the PHE and what’s temporary through the end of the calendar year of the PHE,” said Richelle Marting, an attorney and certified coder in Olathe, Kansas. “If the PHE is simply allowed to expire, you may wake up on a Monday and literally not have the same coverage you had on a Friday.”

A CMS official explained in a Dec. 1 national call on the MPFS that “we didn’t feel we should cut off access [to telehealth services] immediately after the end of the PHE.” But CMS can only go so far on a permanent basis. At some point after the PHE, Medicare telehealth coverage again will be limited by the originating site and rural area requirements, he noted. The originating site requirement restricts coverage to services delivered to patients at hospitals and other provider locations (not patient homes), and the rural area requirement limits coverage to counties outside a metropolitan statistical area or in a rural health professional shortage area. Only Congress can eliminate these requirements. For now, though, Medicare pays for telehealth services in all corners of the country.

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