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CMS Proposes Telehealth Changes for CY 2012

In the recently released Proposed Physician Fee Schedule for calendar year (“CY”) 2012, the Centers for Medicare & Medicaid Services (“CMS”) proposes the addition of new codes to the list of Medicare telehealth services. After reviewing numerous submitted requests, CMS only proposes the addition of smoking cessation services as approved Medicare telehealth services for CY 2012. Despite submitted requests, CMS did not propose the addition of critical care services, domiciliary or rest home evaluation and management services, genetic counseling services, online evaluation and management services, data collection services, and audiology services to the list of approved Medicare telehealth services.

CMS also proposes new criteria for how additional services are added to the list of approved Medicare telehealth services in the future. The proposed changes would shift CMS’ evaluation focus to the clinical benefit of a telehealth service from the current approach which focuses on whether the service has a corresponding in-person equivalent. CMS notes that the revised telehealth criteria would have no effect in CY 2012 as the criteria would only impact the evaluation of telehealth services discussed in future proposed rules.

CMS expects the proposed telehealth changes to increase access to health care, especially in rural areas of the country.

For more information regarding the CMS Proposed Physician Fee Schedule for CY 2012 or professional assistance navigating the ever-evolving healthcare landscape, please contact Adrienne Dresevic, Esq. or Carey F. Kalmowitz, Esq. at (248) 996-8510 or (212) 734-0128, or visit the HLP website.

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