Permanently higher telehealth pay rates under review, CMS says

Laura Dyrda (Twitter) -

CMS Administrator Seema Verma discussed the prospects for extending telehealth coverage and pay rates permanently during a recent STAT virtual event.

"I can't imagine going back," she said during the event. But it may not be up to her. While Ms. Verma and President Donald Trump have repeatedly touted the gains telehealth has made for CMS beneficiaries during the pandemic, the federal government has not finalized permanent changes that would expand access to telehealth and coverage rates.

During the pandemic, CMS made telehealth available to all beneficiaries. Previously, it would only cover telehealth in specific regions and circumstances. The rates were also lower than in-person visits and did not include audio-only visits. One of the reasons telehealth was able to expand so rapidly in the last few months was because of the coverage changes.

"People recognize the value of (telehealth), so it seems like it would not be a good thing to force our beneficiaries to go back to in-person visits," Ms. Verma said, mentioning that virtual visits increased 40-fold in some places during the pandemic.

However, in a CMS press release on June 9, Ms. Verma also acknowledged the value of in-person visits as healthcare facilities reopen for elective care.

"While telehealth has proven to be a lifeline, nothing can absolutely replace the gold standard: in-person care," she said.

Ms. Verma also said the government was evaluating whether to permanently pay the same rates for telehealth visits as in-person visits. A permanent nationwide expansion would be up to Congress because current laws limit coverage, she said.

More articles on telehealth:
How UPMC plans to sustain 50% of telemedicine growth post pandemic: Q&A with CMIO Dr. Robert Bart
3 states move to make telehealth coverage permanent
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