[TAO] Fwd: MEDICARE UPDATES

Catherine Britain csbritain at gmail.com
Fri Jul 10 11:22:02 PDT 2020 

Here are some CMS updates to their policies pertaining to Medicare.

---------- Forwarded message ---------
From: Center for Connected Health Policy <info at cchpca.org>
Date: Fri, Jul 10, 2020 at 11:15 AM
Subject: MEDICARE UPDATES
To: <csbritain at gmail.com>


Includes: CMS Updates FQHC/RHC Factsheet w/ Telehealth Cost Sharing
Infoformation;  CMS June Updates to COVID-19 FAQs;  CMS Telehealth eCQMs
Guidance
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=b821e8902c&e=537bebe328>
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*CMS Updates FQHC/RHC Factsheet with Telehealth Cost Sharing Information*

Earlier this week, the Centers for Medicare and Medicaid Services
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=e3458c4c61&e=537bebe328>
(CMS) released an update to their Medicare Learning Network (MLN) factsheet
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=a4693afc76&e=537bebe328>
for federally qualified health centers (FQHCs) and rural health clinics
(RHCs) during the COVID-19 public health emergency (PHE).  The update
includes a section on the telehealth cost sharing waiver.  CMS specifies
that for CPT/HCPCS codes that are included in the telehealth codes list
that qualify as preventative services, the modifier ‘CS’ should be included
in the claim to indicate that the cost sharing is waived.  The same applies
for COVID-19 testing-related services.  RHCs must report G2025 on their
claim with the CG and CS modifier and FQHCs must report G2025 with the CS
modifier on the claim on or after July 1, 2020.  See the MLN Factsheet
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=21e432b930&e=537bebe328>
for examples of proper coding examples.
------------------------------

*CMS June Updates to COVID-19 FAQs*

In June CMS released an update to their FAQs on Medicare Billing
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=9a6a821722&e=537bebe328>
during the COVID-19 emergency.  Questions center around a wide variety of
topics, but many relate to telehealth. Examples of the telehealth questions
clarified in the June update includes:

   - What types of health care practitioners are permitted to furnish
   telehealth services under broadened 1135 waiver authority granted by the
   CARES Act?
   - Is any specialized equipment needed to furnish Medicare telehealth
   services?
   - What about beneficiaries who do not have access to smart phones or
   other technology that supports two-way, audio and video telecommunications
   technology or patients that do not want to use video?
   - What is changing about the process by which CMS adds services to the
   Medicare telehealth list?
   - What should practitioners consider while setting up agreements with
   vendors of telehealth and telecommunication technology to ensure that
   telehealth is accessible to all patients?
   - How will recently enacted legislation allow CMS to utilize Medicare
   telehealth to address the declared COVID-19 public health emergency (PHE)?
   - Are telehealth services limited to services for patients with COVID-19?
   - Can physicians and other practitioners furnish Medicare telehealth
   services to beneficiaries in their homes?

For answers to these, and many more questions, check out the Frequently
Asked Questions (FAQ) Factsheet
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=4002c7f179&e=537bebe328>.

------------------------------

*CMS Telehealth eCQMs Guidance *

The Centers for Medicare and Medicaid Services released a guidance document
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=a6d17e194e&e=537bebe328>
on the allowance for telehealth encounters to count for the eligible
professional/eligible clinician electronic clinical quality measures (eCQM)
used in CMS quality reporting programs for performance period 2021.  This
would apply to the following programs:

   - Quality Payment Program: The Merit-based Incentive Payment System
   (MIPS) and Advanced Alternative Payment Models (Advanced APMs)
   <https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=d429428f15&e=537bebe328>
   - APM: Comprehensive Primary Care Plus (CPC+)
   <https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=3861ba07ab&e=537bebe328>
   - APM: Primary Care First (PCF)
   <https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=85f270f181&e=537bebe328>
   - Medicaid Promoting Interoperability Program for Eligible Professionals
   <https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=51f6869696&e=537bebe328>

See the guidance
<https://cchpca.us9.list-manage.com/track/click?u=c9fa99b7520aedfca5c453103&id=72ae030e16&e=537bebe328>
for a full list of the 39 telehealth-eligible eCQMs for the 2021
performance period.

*Stay tuned to CCHP’s newsletters for future updates.*
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-- 
Catherine S. Britain, Executive Director
Telehealth Alliance of Oregon
csbritain at gmail.com
541-910-7366
www.ortelehealth.org
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