More on Telehealth

CMS issues its first proposal to continue telehealth flexibilities, in home health proposed rule

The proposed rule also updates home health payment rates for 2021. 

Susan Morse, Managing Editor

For the first time, the Centers for Medicare and Medicaid Services is proposing to make temporary telehealth provisions under COVID-19 permanent.

CMS has issued a proposed rule to make permanent regulatory changes to telecommunications technologies in providing care under the Medicare home health benefit beyond the expiration of the public health emergency for the COVID-19 pandemic.

The rule proposes to permanently finalize, beginning January 1, 2021, the amendment to the home health regulations outlined in a March 30 interim final rule responding to the COVID–19 public health emergency.

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This means that home health agencies can continue to use telehealth in providing care to beneficiaries as a home health benefit, as long as the telecommunications technology is related to the skilled services being furnished, is outlined on the plan of care and is tied to a specific goal indicating how such use would facilitate treatment outcomes.

The use of technology may not substitute for an in-person home visit that is ordered on the plan of care and cannot be considered a visit for the purpose of patient eligibility or payment. 

However, the use of technology may result in changes to the frequencies and types of in-person visits as ordered on the plan of care, CMS said.
This rule also proposes to allow home health agencies to continue to report the cost of telecommunications technology as allowable administrative costs on the home health agency cost report. 


These proposed changes are one of the first flexibilities provided during the COVID-19 public health emergency that CMS is proposing to make a permanent part of the Medicare program. 

These proposals ensure patient access to the latest technology and give home health agencies predictability in continuing to use telehealth.


The proposed rule also updates home health payment rates for 2021. 

CMS estimates that Medicare payments to home health agencies in 2021 would increase in the aggregate by 2.6%, or $540 million, based on the proposed policies. 

This increase reflects the effects of the proposed 2.7% home health payment update percentage (a $560 million increase) and a 0.1% decrease in payments due to reductions made in the rural add-on percentages mandated by the Bipartisan Budget Act of 2018 for 2021 (a $20 million decrease). 

This rule includes a proposal to adopt the revised Office of Management and Budget statistical area delineations, and it proposes to apply a 5% cap on wage index decreases next year.

This rule proposes to implement Medicare enrollment policies for qualified home infusion therapy suppliers, and proposes payment rates using the 2021 physician fee schedule amounts. 


Telehealth use has skyrocketed during the pandemic, as CMS relaxed rules for its use during the emergency.

Twitter: @SusanJMorse
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