CMS Proposes Expanded Medicare Telehealth Coverage

The Centers for Medicare & Medicaid Services (CMS) is proposing to expand Medicare coverage for telehealth services and to make it easier for physicians to provide care through in-person home visits.

The policy changes were floated in a proposed rule issued Thursday, regarding payment policies, rates and quality provisions for services provided under the Medicare Physician Fee Schedule on or after Jan. 1, 2019.

Two payment provisions related to communication technologies would expand the ability of physicians to connect remotely with patients in their homes.


Under one proposal, practitioners would be paid for checking in with a Medicare beneficiary over the phone or through another telecommunication device, to determine whether an office visit is needed. CMS is also proposing to pay practitioners for reviewing photos or videos transmitted by a patient, to determine whether an office visit is required.

In addition, the proposed rule seeks to expand Medicare coverage of telehealth to include prolonged preventive services.

“Getting to the doctor can be a challenge for some beneficiaries, whether they live in rural or urban areas,” CMS noted in announcing the proposals. “Innovative technology that enables remote services can expand access to care and create more opportunities for patients to access personalized care management as well as connect with their physicians quickly.”


In another shift that could make it easier to provide care in people’s homes, the agency is moving to eliminate the requirement that physicians need to justify the medical necessity of a home visit rather than an office visit.

CMS is accepting public comment on the rule through Sept. 10.

Written by Tim Mullaney

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