Expansion of Telehealth with 1135 Waiver


The Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare E-Visit services so that beneficiaries can receive a broader range of services from their doctors without having to travel to a healthcare facility.

Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020. A range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, will be able to offer telehealth to their patients.  

Prior to this waiver, Medicare could only pay for telehealth on a limited basis: when the person receiving the service is in a designated rural area and when they leave their home and go to a clinic, hospital, or certain other types of medical facilities for the service. 

  • "These visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits".
  • "Starting March 6, 2020, and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings". 
  • "While they must generally travel to or be located in certain types of originating sites such as a physician’s office, skilled nursing facility or hospital for the visit, effective for services starting March 6, 2020, and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any healthcare facility and in their home".


MEDICARE TELEHEALTH VISITS:  Currently, Medicare patients may use telecommunication technology for office, hospital visits, and other services that generally occur in-person. 

VIRTUAL CHECK-INS: In all areas (not just rural), established Medicare patients in their home may have a brief communication service with practitioners via a number of communication technology modalities including synchronous discussion over a telephone or exchange of information through video or image.

E-VISITS:  In all types of locations including the patient’s home, and in all areas (not just rural), established Medicare patients may have non-face-to-face patient-initiated communications with their doctors without going to the doctor’s office by using online patient portals.

For home health agencies the E-visit may allow F2F visits to be done in the safety of the patient’s home during this time of quarantine and social distancing.  Home health agencies may potentially be on the front lines of patient management in the coming weeks as we serve the most vulnerable population in the country. 

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