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FAQs on Medicare Coverage of Telehealth
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Published: May 23, 2022
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Telehealth, the provision of health care services to patients from providers who are not at the same location, has experienced a rapid escalation in use during the COVID-19 pandemic, among both privately-insured patients and Medicare beneficiaries. Prior to the pandemic, telehealth utilization among traditional Medicare beneficiaries was extremely low, with only 0.3% of traditional Medicare beneficiaries enrolled in Part B using telehealth services in 2016. Between 2019 and 2020, the number of telehealth visits in traditional Medicare increased 63-fold. During the first year of the pandemic, more than 28 million Medicare beneficiaries overall used telehealth services, including almost half (49%) of Medicare Advantage enrollees and nearly 4 in 10 (38%) beneficiaries in traditional Medicare.
These FAQs provide answers to questions about Medicare’s current coverage of telehealth, changes made at the outset of the public health emergency, additional changes adopted by Congress and the Administration, and some of the policy considerations that lie ahead.
What is the current scope of Medicare telehealth coverage and how did it change at the start of the COVID-19 pandemic?
Under current law and regulations, Medicare covers a broad scope of services via telehealth without restrictions that were in place prior to the COVID-19 pandemic, but, for the most part, this broader coverage is available only temporarily. People with Medicare can now access telehealth services, whether in urban or rural areas, at home or in other settings, using audio-visual or audio-only technologies, and from a wide range of health care providers. This is due to a broad but time-limited expansion of telehealth coverage in Medicare during the COVID public health emergency. To make it easier and safer for beneficiaries to seek medical care during the pandemic, in March 2020, the Secretary of the Department of health and Human Services (HHS) waived certain restrictions on Medicare coverage of telehealth services for Medicare beneficiaries during the COVID-19 public health emergency, based on waiver authority included in the Coronavirus Preparedness and Response Supplemental Appropriations Act (and as amended by the CARES Act) (Figure 1). The public health emergency was most recently renewed in April 2022, and the Biden Administration has said that it will provide a 60-day notice before allowing the public health emergency to expire. Because the Biden Administration has not yet provided a 60-day notice that the public health emergency will end, it is likely the PHE will extend beyond July.