As with any type of medical billing, office practices must follow the most current payer guidelines. Early in the pandemic, telehealth regulatory and billing concessions changed almost daily. As the pandemic continued, the declared public health emergency (PHE) was repeatedly extended. Many state-level concessions were and are still dependent on the presence of a current PHE declaration. In a letter to state governors released on January 21, 2021, Acting Secretary of Health and Human Services Norris Cochran extended the PHE an additional 90 days and signaled his intent to maintain the PHE through 2021 (see PHE Message to Governors). The letter also advises that governors will be given a 60-day notice before the PHE is rescinded. Medical offices are advised to follow their state medical society and professional association websites for updates on PHE declaration status.
The Centers for Medicare and Medicaid Services (CMS) included telehealth and communications technology in the final 2021 Physician Fee Schedule (see Federal Register Rule 86 FR 5020). Significant remote patient monitoring clarifications include refining the interactive communication definition to incorporate “care management services and synchronous, real-time interactions”; permitting informed consent to be obtained at the initiation of service instead of in advance; clarifying the supervisory requirements for service provision by “auxiliary” personnel; and expanding coverage to acute conditions. CMS provides a brief summary of the COVID-19 PHE Category 3 telehealth billing updates in its December 1, 2020, Fact Sheet. Medical offices are advised to be alert for third-party payer contract updates and changes when the PHE is rescinded and when state legislatures reconvene.