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  • COVID-19: Here’s What CMS Will Do With the Temporary Telehealth Codes When the PHE Ends

    Rachel B. Goodman and Nathaniel M. Lacktman, Foley & Lardner LLP

    The Centers for Medicare & Medicaid Services (CMS) recently issued its proposed 2021 Physician Fee Schedule rule, enumerating the services CMS proposes to add (and remove) from the list of telehealth services covered under Medicare. This year’s list is unusually robust because CMS took into consideration all the telehealth services Medicare currently covers on a temporary basis due to the COVID-19 Public Health Emergency (PHE). 

    CMS grouped the telehealth services into three lists: 1) nine (9) codes that will become permanent; 2) seventy-four (74) codes that will be removed when the PHE expires; and 3) thirteen (13) codes to add to the list, but only on a temporary basis (CMS dubbed these Category 3 codes). Concurrent with the CMS proposed rule, the White House issued an Executive Order designed to enhance access to telehealth services under Medicare by charging CMS to create even more virtual care coverage opportunities. 

    This article discusses the new Medicare telehealth service code proposals specifically related to the Public Health Emergency. For a companion piece discussing CMS’ proposed 2021 changes for Medicare telehealth and virtual care generally, click here

    Telehealth services that will become permanent

    CMS proposed adding nine codes to the list of telehealth services covered under Medicare, to remain covered even after the PHE ends. The codes are set forth in the table below.

    Service Type  HCPCS/CPT Codes 
    Group Psychotherapy  90853
    Domiciliary, Rest Home, or Custodial Care services, Established patients 99334-99335 
    Home Visits, Established Patient  99347- 99348 
    Cognitive Assessment and Care Planning Services  99483 
    Visit Complexity Inherent to Certain Office/Outpatient E/Ms  GPC1X 
    Prolonged Services 99XXX 
    Psychological and Neuropsychological Testing  96121 

    Keep in mind, these codes are already Medicare-covered telehealth services, albeit on a temporary basis under the PHE waiver rules. Subject to CMS’ final rule, these services are expected to be added, on a permanent basis, effective January 1, 2021.

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