Medicare Payment Advisory Commission (MedPAC): June 2023 Report to the Congress: Medicare and the Health Care Delivery System

MedPAC released its June 2023 report to Congress, which includes 10 chapters, including the mandated report to Congress on telehealth in Medicare. As mandated by the Consolidated Appropriations Act, 2022, the Commission presents data on the use of telehealth services during the public health emergency and an analysis of the relationship between expanded telehealth coverage and quality, access, and costs.

Key takeaways:

  • MedPAC recommends that CMS should resume paying the lower, facility rate for telehealth services as soon as practicable after the PHE.
  • MedPAC supports paying FQHCs and RHCs for telehealth services after the PHE at rates that are comparable with PFS rates for telehealth services.
  • In 2020 and 2021, E&M services accounted for almost all (98 percent) of PFS telehealth spending. Mental, behavioral, and neurodevelopmental disorders accounted for the highest share of spending for telehealth in 2021 (34.4 percent), which was a higher share than in 2020 (25.4 percent).
  • Telehealth visits generally took less time than in-person visits, but the claims data found that the times were about the same for in-person and telehealth visits in 2021. MedPAC notes that “If the time clinicians spend with patients is typically shorter during telehealth services than in-person visits, a smaller share of telehealth visits should be coded at higher levels (more time spent) than in-person visits.”
  • Greater telehealth use was associated with little change in measured quality, slightly improved access to care for some beneficiaries, and slightly increased costs to the Medicare program.
    • MedPAC recommends to Congress to continue monitoring the impact of telehealth to inform any permanent policy.