Post-Pandemic Medicare Telehealth Benefits

November 23, 2022
Danielle Pierce

During the COVID-19 pandemic, the concept of telehealth quickly spread and has become a standard service offering for healthcare providers. Telehealth medicine became essential, as it ensured people could maintain non-emergent medical services during the pandemic. To protect providers and patients and encourage social distancing, the Centers for Medicare & Medicaid Services (CMS) temporarily allowed Medicare telehealth benefits that were not allowed previously. As a result, the medical community were able to continue treating a vulnerable community during a global health crisis. As concerns about COVID-19 abate, telehealth services (and benefits) remain one of the lingering, positive changes that came about as a result of the pandemic.

How COVID-19 Led to Temporary Expanded Medicare Benefits

Before the pandemic, virtual appointments were only available to patients in rural or remote areas, which only included about 20% of Medicare beneficiaries. Additionally, most patients would have to go to an “originating site” at a healthcare facility to use this service.

During the pandemic, all Medicare beneficiaries gained at-home access to telehealth services. This eliminated the requirement to drive to an originating site and lifted the limitations set by geographical locations. Additionally, patients no longer needed an existing patient-provider relationship to receive virtual services.

Americans seamlessly transitioned from in-person to virtual medical services in most fields. As time passed, the benefits of telehealth became more apparent as it was comfortable, convenient, and flexible for both patients and providers. However, Medicare beneficiaries who benefited from telehealth services became concerned about the availability once the federal public health emergency (PHE) order ended.

The Permanent Expansion of Benefits

The PHE was projected to end on October 13, 2022. However, the 2022 Consolidated Appropriations Act extended the expanded Medicare telehealth coverage for 151 days beyond the end of the PHE. This allows for an adjustment period for those no longer receiving coverage. Fortunately, Medicare has announced the permanent coverage of some telehealth benefits.

Here is what you need to know about Medicare’s permanent expansion of telehealth benefits.

Many services added during the COVID-19 pandemic will be on the fee schedule permanently.
Medicare beneficiaries can now receive telehealth care for mental and behavioral health, including audio-only services, at home under certain conditions.
Video-based mental health visits for Rural Health Clinics and Federally Qualified Health Centers

Temporary Medicare Telehealth Benefits

The expanded list of telehealth providers will only be covered through the 151-day PHE extension period.
The in-home flexibility, which allowed patients to utilize telehealth without going to an originating site
Coverage for audio-only telehealth services
After the 151-day extension period is over, mental health telehealth services coverage will require an in-person visit within six months of the first assessment and every 12 months after.

Before the COVID-19 pandemic, Medicare telehealth benefits were very limited. After the federal Public Health Emergency was made effective in January 2020, 144 Medicare services were added to the list of telehealth coverage. While many Americans have adapted to the convenience and comfort of telehealth, many of these policies will end once the PHE extension concludes. However, we remain hopeful the CMS will expand the program upon review of data and research collected during the PHE and its extension.

The team at Pierce Legal provides legal advice and guidance focused on the areas of asset protection through proper estate planning, including pre-planning for long-term care our clients may need as they age. We understand the need to create an estate plan that will protect your family’s legacy. We can help guide and support our aging population (and their families) to draft an individualized estate plan that will need each of our client’s specific needs. Contact us today to schedule a consultation at (330) 588-6115.