Medicare Will Expand Coverage for Telehealth

By Ken Terry,  Information Week – Healthcare

The Centers for Medicare and Medicaid Services (CMS) has proposed changing how it defines telehealth services that may be eligible for Medicare coverage. But it’s unclear how far the agency will go in expanding such coverage.

In its proposed rule on changes in physician payment, CMS said that it would consider the proven clinical benefits of a telehealth service in deciding whether to cover that service. Up to now, providers have had to show that a telehealth service is “equivalent when furnished in person or through telehealth”–a criterion that CMS calls the “comparability standard.”

The agency’s proposed switch to a standard based on clinical benefit “would likely improve access to care by expanding the list of services eligible to be delivered via telehealth,” according to a CMS fact sheet.

But, while telehealth supporters would like to see coverage of tele-stroke, tele-ICU, and some other established telehealth services, CMS specifically states that it does not believe it should cover the remote provision of critical care services.

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