CMS Expanded PHE Telehealth Services List

Posted Alliance for Connected Care COVID-19, Press Release

CMS added 11 new services to the Medicare telehealth services list on a subregulatory basis. Medicare will begin paying eligible practitioners who furnish these newly added telehealth services effective immediately, and for the duration of the PHE.

These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services. A chart with descriptors is included below. As you remember the May 1, 2020, COVID-19 Interim Final Rule with comment period (IFC) provided CMS with the authority to add codes on a subregulatory basis. The comprehensive list us updated at https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes.

Also, CMS released a new supplement to its State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version that provides numerous new examples and insights into lessons learned from states that have implemented telehealth changes.

Find more information at https://www.cms.gov/newsroom/press-releases/trump-administration-drives-telehealth-services-medicaid-and-medicare

New Medicare Telehealth Services

93797Cardiac rehabPhysician services for outpatient cardiac rehabilitation; without continuous ECG monitoring [per session]
93798Cardiac rehab/monitorPhysician services for outpatient cardiac rehabilitation; with continuous ECG monitoring [per session]
93750Interrogation vad in personInterrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming
95970Alys npgt w/o prgrmgElectronic analysis of implanted neurostimulator pulse generator/transmitter (e.g., contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain, cranial nerve, spinal cord, peripheral nerve, or sacral nerve, neurostimulator pulse generator/transmitter, without programming.
95971Alys smpl sp/pn npgt w/prgrmElectronic analysis of implanted neurostimulator pulse generator/transmitter (e.g., contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with simple spinal cord or peripheral nerve (e.g., sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional.
95972Alys cplx sp/pn npgt w/prgrmElectronic analysis of implanted neurostimulator pulse generator/transmitter (e.g., contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with complex spinal cord or peripheral nerve (e.g., sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional.
95983Alys brn npgt prgrmg 15 minElectronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain neurostimulator pulse generator/transmitter programming, first 15 minutes face-to-face time with physician or other qualified health care professional
95984Alys brn npgt prgrmg addl 15Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain neurostimulator pulse generator/transmitter programming, each additional 15 minutes face-to-face time with physician or other qualified health care professional
G0422 Intens cardiac rehab w/exercIntensive cardiac rehabilitation; with or without continuous ECG monitoring with exercise, per session
G0423Intens cardiac rehab no exerIntensive cardiac rehabilitation; with or without continuous ECG monitoring; without exercise, per session
G0424Pulmonary rehab w exerPulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day

CMS also released a new data snapshot on telehealth utilization among Medicaid and CHIP beneficiaries during COVID-19. The data includes services use through June 30, 2020.

  • Children: Telehealth rates among children peaked in April for nearly all states and began to fall in May. Across states in April 2020, Maine had the highest monthly rate at 402 services per 1,000 child beneficiaries, and Vermont had the lowest monthly rate at 23 services per 1,000 child beneficiaries.
  • Adults: Telehealth rates among working age adults peaked in April for nearly all states and began to fall in May. Across states in April 2020, Missouri had the highest monthly rate at 520 services per 1,000 beneficiaries age 19 to 64, and South Carolina had the lowest monthly rate at 51 services per 1,000 beneficiaries age 19 to 64.
  • Adults 65+: Telehealth rates among adults age 65+ also peaked in April for nearly all states and began to fall in May. Across states in April 2020, Maryland had the highest monthly rate at 363 services per 1,000 beneficiaries, and South Carolina had the lowest monthly rate at 23 services per 1,000 beneficiaries.