Medicare Telehealth Coverage Expands
Before the pandemic, few people receiving Medicare used telehealth services, which allow patients to connect with providers through the internet. A telehealth appointment is a real-time, full-service visit with a health care professional. The critical distinction between a telehealth visit and a regular appointment is that a telehealth meeting takes place remotely through technology.
According to the Kaiser Family Foundation, only 0.3% of people enrolled in Medicare Part B used telemedicine before the COVID-19 crisis. At that time, Telehealth was available only for people who lived in rural locations and patients had to travel to an office to connect virtually with medical practitioners. Only certain providers — doctors and nurse practitioners — could offer telemedicine, and fewer services were available.
Medicare Telehealth in 2020
Due to the pandemic, the number of Medicare beneficiaries using telehealth services increased in 2020.
- More than 28 million people on Medicare used telemedicine services
- 49% of people enrolled in Medicare Advantage accessed health care online
- 38% of traditional Medicare beneficiaries relied on telemedicine
In response to the COVID-19 crisis, the regulations governing telemedicine also changed to allow Medicare beneficiaries more options for remote providers and services.
- Emergency department visits
- Physical therapy
- Occupational therapy
- Evaluation and management
- Behavioral health services
Current Medicare Telehealth Services
The new federal regulations have expanded access to telehealth services. Rather than traveling to the doctor’s office, Medicare beneficiaries can have appointments over the internet.
- Federal law has increased the types of providers available via telemedicine, going beyond doctors and nurse practitioners to include professionals such as speech therapists, physical therapists, and occupational therapists.
- Whereas telehealth used to be an option only for people who lived in rural locations, Medicare beneficiaries are now eligible for telemedicine appointments regardless of where they live.
Medicare currently covers many telehealth services, such as:
- Lab tests
- X-ray consultations
- Chronic condition treatments
- Post-surgery appointments
- Prescription management
- Psychotherapy and mental health treatment
- Preventative screenings
- Urgent care appointments
Cost of Medicare Telehealth Services
Although the COVID-19 pandemic expanded access to telemedicine, the cost structure for remote health services has remained the same.
- Medicare’s Part B covers telehealth services.
- In 2022, beneficiaries are subject to a $233 deductible and 20 percent copay.
The Role of Federal Law
With the coronavirus pandemic, federal laws expanded the telemedicine options available to Medicare beneficiaries.
- In January 2020, the Secretary of Health and Human Services declared an official public health emergency.
- In March 2020, the Coronavirus Preparedness and Response Supplemental Awareness Act and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) gave the Secretary of the Department of Health and Human Services the authority to waive Medicare coverage restrictions during the COVID-19 public health emergency.The CARES Act allowed federally qualified health centers — outpatient clinics that qualify for reimbursement under Medicare — and rural health centers to offer telehealth services to Medicare beneficiaries.
- In December 2021, the Consolidated Appropriations Act of 2021 increased remote mental health services available to Medicare recipients. The Act allows audio-only mental health services and provides that internet mental health care will remain open to Medicare beneficiaries permanently — even after the end of the public health emergency.
- In March 2022, Consolidated Appropriations Act provides that telemedicine services tied to the pandemic emergency will continue for five months after the federal government officially declares it is over.
- In April 2022, the Secretary of Health and Human Services renewed the public health emergency, continuing to mandate expanded telehealth coverage to Medicare beneficiaries.
- If the Biden administration ends the public health emergency, it will provide 60 days’ notice. As of September 2022, the public health emergency continues, and the telemedicine services tied to the crisis continue to be available to people using Medicare.
- If the Senate passes it, the Advancing Telehealth Beyond COVID-19 Act of 2021 will extend Medicare coverage of many telehealth services to 2024.
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