Telehealth/Telemedicine Regulations Update: Through the COVID-19 Public Health Emergency and Beyond

A recent study revealed that telehealth usage has increased 38 times from before the COVID-19 pandemic.  While this level of use is down from the early months of the pandemic, it has remained at 13-17% of office and outpatient visits.  Both patients and providers have demonstrated willingness to use telehealth.  Regulatory changes have allowed for expanded use of telehealth services; however, actions must be taken at the federal and state levels to make many of those changes permanent once the Public Health Emergency (PHE) expires.

On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the 2022 Physician Fee Schedule (PFS).  CMS is continuing to evaluate telehealth services which were temporarily added under the PHE.  As such, certain telehealth services will be extended through December 31, 2023, even if the PHE expires prior to that date.  The intent of the extension is to allow more time for CMS and stakeholders to gather data and submit support for telehealth services which should be permanent.


CMS did add that the home of the beneficiary may be an originating site for telehealth services for mental health disorders.  However, there must be an in-person, non-telehealth service within six months prior to the initial telehealth service.  An exception can be made if clear medical record documentation exists based on beneficiary circumstances.  In addition, audio-only mental health communications will be permissible if the beneficiary is not capable or does not consent to the use of two-way audio/video technology.


Congress continues to introduce telehealth legislation, including the Expanded Telehealth Act which would extend reimbursement to physical and occupational therapists, audiologists, and speech language pathologists.  This most recent bill, along with the Telehealth Modernization Act, the CONNECT for Health Act of 2021 (Creating Opportunities Now for Necessary and Effective Care Technologies), the Protecting Rural Telehealth Access Act, and the Telemental Healthcare Access Act of 2021 continue to move through the federal legislative process.

The Center for Connected Health Policy publishes biannual reports on state telehealth laws and reimbursement policies along with an online database of current laws and policies by federal and state jurisdictions.  A key finding in their most recent report is “No two states are alike in how telehealth is defined and regulated.”

Excelas will continue to monitor developments related to telehealth/telemedicine and its impact in the long-term care setting.

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