What You Need to Know About Telemedicine Coverage With Medicare

With the ongoing safety concerns of the pandemic, many people are doing more day-to-day activities remotely than ever before. Doctor’s visits are no exception, with the once niche area of telemedicine becoming a part of routine care.
As more people seek out telemedicine coverage, insurance companies have had to adapt quickly to the changing ways patients are interacting with medicine. For Medicare beneficiaries, the number of procedures covered through telemedicine has been widely expanded.
However, not all of that expansion will last after the COVID-19 pandemic has subsided. Medicare patients who may be enjoying the convenience of telemedicine should know how this coverage will continue on after the health crisis is over.
COVID-19’s impact on telemedicine
Beginning in March, Medicare began covering many more services through telemedicine to meet people’s changing needs in regards to social distancing.
Prior to March 2020, only about 15,000 Original Medicare beneficiaries used telehealth services on a weekly basis. Between mid-March and mid-October last year, that number exploded to over 24.5 million beneficiaries.
144 new telehealth services are being covered during the officially declared public health emergency due to COVID-19. But while many people, both doctors and patients, have been impressed by the convenience and efficacy of telehealth services, many of these services may not continue to be covered after the public health emergency ends.
Looking towards the future of remote medicine
In December of 2020, nine out of the 144 new telehealth services were established as now receiving permanent coverage through Medicare.
59 of the 144 services will continue to be covered through the calendar year in which the public health emergency ends, and the efficacy of telehealth treatments will be reviewed to see if those services will be permanently covered.
But even the permanent additions will see their reach severely limited after the pandemic. Medicare is currently restricted from permanently covering telehealth services outside of rural areas or areas lacking enough medical personnel.
The areas that will have continued expanded telehealth coverage are designated HPSAs, or Health Professional Shortage Areas. The only permanent exceptions to this restriction are mental health care, acute stroke treatment and treatment of end-stage renal disease (ESRD).
Unfortunately, these restrictions will impact nearly all Medicare beneficiaries, even those with high supplemental coverage through Medicare supplement plans (also known as Medigap) or Medicare Advantage Plans. Without reimbursement through Medicare doctors won’t be able to provide these services to Medicare beneficiaries regardless of coverage type.
Telephone services are an open question
Telephone-only medical services only began being covered by Medicare in March with the declaration of the public health emergency. These services also aren’t included in the extensions mentioned above.
This is an important exception because as many as 40% of people who rely on Medicare have access to a phone, but not a computer with the internet. Telephone services are able to reach a large number of Medicare patients that even other telehealth services are inaccessible to.
Source: iQuanti, Inc.