In January 2023, the Centers for Medicare & Medicaid Services (CMS) rolled out a new telehealth “indicator” to make information about Medicare telehealth providers on publically-available clinician profile pages more readily available. The new indicator will allow patients and caregivers to easily identify which providers are approved and available to deliver telehealth services. The new indicator has been developed to assist Medicare beneficiaries in finding appropriate providers due to the high demand for providers offering telehealth services. In response, CMS has approved an unprecedented COVID-19 public health emergency (PHE) expansion of Medicare payment for telehealth services.
Research Supporting Use of the Telehealth Indicator
CMS has made many changes in direct response to public demand for continued telehealth services, consumer satisfaction with telehealth, and several published reports indicating strong positive outcomes for telehealth. Two primary reports used by Medicare to substantiate the continued approval of Medicare payment for telehealth showed a 30-fold increase in telehealth services, with more than half of Medicare beneficiaries using these services between March 1, 2020, and February 28, 2021. Those studies include the following:
- September 2021 Medicare Telemedicine Snapshot1 CMS, Medicare Telemedicine Snapshot: March 2020–Feb. 2021 (2021)
- Medicare Telemedicine Snapshot Data File
These studies not only reflect the growth in patients seeking telehealth due to the ongoing Public Health Emergency (PHE) but also help to substantiate and legitimize CMS funding for telehealth service reimbursement, particularly for behavioral telehealth. Supportive studies also fueled the recent expansion of approved Medicare providers to include mental health counselors, marriage and family therapists, and other specialty providers who previously were denied reimbursement despite being licensed. Adding an indicator to clinician profile pages in the Medicare Care Compare and the Provider Data Catalog (PDC) is intended to clarify which clinicians offer telehealth services for website users.
Benefits of the Telehealth Indicator
As outlined in the CMS public webpage explaining the telehealth indicator initiative, the addition of the indicator is also the result of a documented history of Medicare beneficiaries searching for telehealth service providers to make informed decisions about their healthcare. Also, CMS’ user testing has shown that users understand the meaning of the indicator and that some also want to know the specific telehealth services offered by clinicians. The CMS announcement of this new telehealth indicator explains that most users found it important and useful when selecting a clinician when calling a Medicare Call Center. Telehealth is also one of the primary service requests they receive monthly from beneficiaries.
In addition, publicly reporting a telehealth indicator on clinician profile pages furthers CMS’s health equity goals. According to the Medicare Telemedicine Snapshot, regardless of gender or Medicare and Medicaid status, more than half of the Medicare population in almost every racial/ethnic group uses some telehealth service. The January announcement explains:
- Given the exponential increase in Medicare telehealth usage by Medicare users over the past two years, particularly by those in areas with limited healthcare access and those who cannot physically access a clinician’s office, publicly reporting information on which clinicians furnish services via telehealth is intended aid in health care provider selection across the Medicare and dually eligible Medicare and Medicaid populations, since some beneficiaries have preferences for, or limitations preventing them from, seeing a clinician in person.
How the Telehealth Indicator Will Work
Once installed, telehealth indicators need to be kept current. To ensure that indicators are accurate, their use will be time-limited. CMS will use a 6-month “lookback period” and automatically refresh the telehealth indicator on clinician profile pages bi-monthly. Also, CMS will allow these indicators on clinician profile pages only. Group profile pages will not reflect the telehealth indicator at this time.
For more information, download the Telehealth Indicator on Medicare Care Compare fact sheet.
Optimizing Telehealth Billing: Current Telehealth CPT Codes & Telehealth Reimbursement Strategies
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