How It Affects Remote Patient Monitoring & Telehealth

On Might 11, 2023, the U.S. COVID-19 public well being emergency (PHE) came to an end. Whereas the declaration was largely symbolic, coming greater than three years after the PHE was declared, it was nonetheless vital from a regulatory perspective in areas together with distant affected person monitoring (RPM) and telehealth.

The COVID-19 pandemic motivated businesses embody the Division of Well being and Human Companies (HHS) and the Facilities for Medicare & Medicaid Companies (CMS) to move quite a few guidelines that helped spur substantial adoption and utilization of RPM and telehealth as a way of serving to sufferers obtain ongoing remedy and help whereas decreasing the dangers related to in-person care. Now with the tip of the PHE, a few of these guidelines are ending. Nonetheless, others have been prolonged or have been made everlasting in the course of the PHE.

Learn on to get caught up on how the tip of the PHE has — or has not — affected these guidelines.

Modifications to Distant Affected person Monitoring and Power Care Administration

The next are PHE-related adjustments that pertain to distant affected person monitoring or power care administration which were reverted to their pre-PHE guidelines with the ending of the general public well being emergency (efficient Might 11, 2023).

16-day/2-day RPM requirement

Medicare suppliers should resume solely billing for the availability of a tool or units used for RPM providers throughout a 30-day interval when a affected person transmits a minimum of 16 days of physiologic information. Notice: The “2-day RPM requirement” related to confirmed circumstances of COVID-19 is not eligible for billing. 

RPM for established sufferers

Clinicians should resume arranging for an initiating go to for sufferers not seen inside the earlier 12 months earlier than clinicians can order and supply distant affected person monitoring providers.

Assortment of Half B copays

Medicare suppliers should resume accumulating the 20% Half B copay from sufferers for telehealth visits.

HIPAA necessities for telehealth platforms

The Workplace of Civil Rights (OCR) is resuming enforcement of HIPAA necessities for telehealth platforms (each RPM/CCM and telemedicine).

Different Everlasting Telehealth Modifications to Know About

The next are PHE-related adjustments to distant affected person monitoring and telehealth which were made everlasting.

Expanded entry to tele-behavioral well being

Medicare sufferers can obtain telehealth providers for behavioral well being/psychological well being care of their dwelling, and there aren’t any geographic restrictions for originating website for tele-behavioral well being providers.

FQHCs and RHCs as distant website supplier for tele-behavioral well being

Federally certified well being facilities (FQHCs) and rural well being clinics (RHCs) can function a distant website supplier for tele-behavioral well being providers.

Audio-only communication for tele-behavioral well being

Tele-behavioral well being providers may be delivered by way of audio-only communication platforms.

REHs as eligible originating websites for telehealth

Rural emergency hospitals (REHs) are eligible originating websites for telehealth

Basic Telehealth Modifications To Know

The next are PHE-related adjustments to telehealth which were a minimum of quickly prolonged previous the tip of the PHE. We’re together with their “efficient by way of” dates, which could possibly be additional prolonged ought to regulators select to take action.

Expanded entry to telehealth

Medicare sufferers can proceed to obtain telehealth providers of their dwelling, with no geographic restrictions for originating website for non-tele-behavioral well being providers. (Efficient by way of a minimum of Dec. 31, 2024)

Expanded telehealth suppliers

Telehealth providers may be offered by all eligible Medicare suppliers. This consists of bodily therapists, occupational therapists, speech language pathologists, and audiologists. (Efficient by way of a minimum of Dec. 31, 2024)

Expanded record of telehealth providers

Medicare suppliers can proceed to supply and invoice for these providers on the expanded list of telehealth services eligible for reimbursement. (Efficient by way of a minimum of Dec. 31, 2023)

Expanded record of tele-behavioral providers

Suppliers can proceed to invoice for these behavioral well being providers added to the expanded record of eligible telehealth providers. (Efficient by way of a minimum of Dec. 31, 2024) 

In-person tele-behavioral well being go to not required

An in-person go to inside six months of an preliminary tele-behavioral well being service, and yearly thereafter, isn’t required. (Efficient by way of a minimum of Dec. 31, 2024)

Continued use of audio-only communication for telehealth

Some telehealth (non-tele-behavioral well being) providers can nonetheless be delivered utilizing audio-only communication platforms. (Efficient by way of a minimum of Dec. 31, 2024)

FQHCs and RHCs as distant website supplier for telehealth

Federally certified well being facilities and rural well being clinics can proceed to function distant website suppliers for telehealth (non-tele-behavioral well being) providers. (Efficient by way of a minimum of Dec. 31, 2024)

Telehealth as an “excepted profit”

Distant affected person monitoring and telehealth are not permitted to be handled as standalone “excepted advantages” supplied by employers to staff (efficient Might 11, 2023).

What’s Subsequent for Distant Affected person Monitoring and Telehealth?

Whereas the tip of the PHE gives some readability to the way forward for RPM and telehealth, a lot stays up within the air. We’re hoping to see a few of the quickly prolonged adjustments made everlasting (excellent news: advocates are pushing exhausting for this to happen) and hoping to see adjustments that additional develop entry to distant affected person monitoring and telehealth.

We’re excited for the way forward for RPM and telehealth. Extra suppliers, payers, and sufferers are tapping into these beneficial providers, and we count on to see continued progress within the digital care area as these providers grow to be extra extensively understood and possible.

We’ll be paying shut consideration to the upcoming Medicare guidelines and numerous items of laws working their method by way of Congress, on the lookout for any RPM and telehealth information and developments after which sharing what we discover and be taught on social media. Observe Prevounce on LinkedIn, Twitter, and Facebook that can assist you keep present.