Medicaid/Medicare Telehealth Billing Information - USA

CMS just issued a final ruling about telehealth medicaid information and I thought I’d post the summary description I got for others to use as well as a link to the federal government website with the listed telehealth billing codes.

Last week, the Center for Medicare and Medicaid Services (CMS) released the final rule for the CY 2023 Medicare Physician Fee Schedule (PFS). CMS finalized many of their telehealth proposals, which primarily focused on what services will be covered by the program and what will happen immediately following the end of the public health emergency (PHE), including during the 151-day grace period included in the 2022 Budget Act. CMS clarified that the list of services that were temporarily allowed to be delivered via telehealth and reimbursed by Medicare during the PHE, will still be allowed during the 151-day grace period. Additionally, CMS added more of the temporary telehealth PHE list codes to a category of services that would remain through the end of 2023. The rule also reiterates the requirement for an in-person visit in the first 6-months of an initial telehealth mental health visit and every 12 months afterward (with exceptions), and clarifies that won’t be implemented until 152 days after the end of the PHE. They will address the specifics around coding and reporting these types of services through guidance and a sub-regulatory process in the future to ensure a smooth transition after the PHE ends. Stay tuned for an in-depth In Focus write up from CCHP on the 2023 PFS next week, as well as a new factsheet focused on the telehealth elements in the final rule.

Here is the federal government’s website on the billing code information for Telehealth billing in 2023.

For those who want to keep up to date on this information I’m subscribed to an email list from the Center for Connected Health Policy which is a great resource for Telehealth policy.

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Sadly, telehealth is not reimbursed as advertised by Medicare, Medicaid, or insurance companies (they don’t seem to follow their own policies). I know a lot of clinics have done away with telehealth.