Miscellaneous
CMS issued a letter to clarify for states that Medicaid and CHIP coverage and payment of interprofessional consultation is permissible, even when the beneficiary is not present, as long as the consultation is for the direct benefit of the beneficiary.
The Secretary shall conduct a study using medical record review, as described in subparagraph (C), on program integrity related to telehealth services under part B of title XVIII of the Social Security Act. See bill for details.
SOURCE: House Bill 2617, (2022 Session), (Accessed Apr. 2025).
In January 2023, the Centers for Medicare & Medicaid Services (CMS) implemented a telehealth indicator on Medicare Care Compare and in the Provider Data Catalog (PDC) to expand the information available to patients and caregivers when choosing doctors or clinicians (87 FR 70109 – 70111). In response to the ongoing COVID-19 public health emergency (PHE), CMS expanded Medicare payment for telemedicine services to improve patients’ access to care.
CMS will add a telehealth indicator to the Physician Compare Finder found on the Medicare website as is applicable and technically feasible.
SOURCE: CY 2023 Physician Fee Schedule, CMS, p. 2089, (Accessed Apr. 2025).
Q7: What are the current guidelines for virtual presence for teaching physicians who furnish telehealth services involving residents?
A7: In the CY 2025 PFS final rule, we established that through December 31, 2025, we are continuing to allow teaching physicians to have a virtual presence in all teaching settings, but only for services furnished as a Medicare telehealth service. This will continue to permit teaching physicians to have a virtual presence during the key portion of the Medicare telehealth service for which payment is sought, through audio/video real-time communications technology, for all residency training locations through December 31, 2025.
Q10: Which services allow virtual direct supervision?
A10: For all services requiring direct supervision, we continue to permit direct supervision to be provided through real-time audio/video only through December 31, 2025. This applies to all services where direct supervision is required, including most incident-to services under § 410.26, many diagnostic tests under § 410.32, pulmonary rehabilitation services under § 410.47, cardiac rehabilitation and intensive cardiac rehabilitation services under § 410.49, and certain hospital outpatient services as provided under § 410.27(a)(1)(iv).In the CY 2025 PFS final rule, we finalized that for a certain subset of services valued under the PFS that are typically performed in their entirety by auxiliary personnel that are required to be furnished under direct supervision, we permanently adopted a definition of direct supervision that allows virtual presence through real-time audio and video communications technology.
SOURCE: CMS, Telehealth FAQ Calendar Year 2025, (Accessed Apr. 2025).
Medicaid Requirements
Unless required by regulation or policy, states are not required to submit a (separate) SPA for coverage or reimbursement of Medicaid coverable services delivered through telehealth if they decide to reimburse for services delivered through telehealth in the same way/amount that they pay for face-to-face services.
States must submit a (separate) reimbursement (attachment 4.19B) SPA if they want to provide reimbursement for services or components of services delivered through telehealth differently than is currently being reimbursed for face-to-face services.
States may submit a coverage SPA to better describe the services they choose to cover through telehealth, such as which providers/practitioners are identified by the state to use telehealth to deliver services; where it is provided; how it is provided, etc. In this case, and in order to avoid unnecessary SPA submissions, it is recommended that a brief description of the framework of telehealth may be placed in an introductory section of the state plan, e.g., Section 3 – Services: General Provisions 3.1 Amount, Duration and Scope of Services, and then a reference made to coverage through telehealth in the applicable benefit sections of the state plan. For example, in the physician section it might say that dermatology services can be delivered via telehealth provided all state requirements related to telehealth as described in the state plan are otherwise met.
SOURCE: Medicaid.gov. Telehealth (Accessed Apr. 2025).
ABN issuance is NOT required in the following HHA situations:…
- telehealth monitoring used as an adjunct to regular covered HH care
Notwithstanding any other provision of law, the Secretary may make payments to or for any person traveling in, to, or from the Freely Associated States for receipt of care or services authorized to be legally provided by the Secretary…
Before delivering hospital care or medical services under subsection (f) of section 1724 of title 38, United States Code, as added by paragraph (2)(B), the Secretary of Veterans Affairs, in consultation with the Secretary of State, shall enter into agreements with the governments of the Freely Associated
States to—
- facilitate the furnishing of health services, including telehealth, under the laws administered by the Secretary of Veterans Affairs to veterans in the Freely Associated States, such as by addressing.
The Secretary of Veterans Affairs may pay tort claims, in the manner authorized in the first paragraph of section 2672 of title 28, United States Code, when such claims arise in the Freely Associated States in connection with furnishing hospital care or medical services or providing medical consultation or medical advice to a veteran under the laws administered by the Secretary, including through a remote or telehealth program.
SOURCE: HR 4366 (2024 Session), (Accessed Apr. 2025).
Through CY 2024, we will continue to permit the distant site practitioner to use their currently enrolled practice location instead of their home address when providing telehealth services from their home. We will also consider this issue further for future rulemaking and request that interested parties provide clear examples of how the enrollment process shows material privacy risks to inform future enrollment and payment policy development. We request further information from interested parties to better understand the scope of considerations involved with including a practitioner’s home address as an enrolled practice location when that address is the distant site location where they furnish Medicare telehealth services.
Teaching physicians may have virtual presence when billing for services provided involving residents in all teaching settings, but only in clinical situations when the service is provided virtually (for example, a 3-way telehealth visit with the patient, resident, and teaching physician in separate locations) through December 31, 2025
For all services, we’ve extended the definition of direct supervision that allows the supervising physician or practitioner to provide supervision through a virtual presence using real-time audio-visual interactive telecommunications through December 31, 2025
For a subset of services, we’ve permanently adopted the definition of direct supervision that allows the supervising physician or practitioner to provide supervision through a virtual presence using real-time audio-visual interactive telecommunications
Veterans Affairs
The Department of Veterans Affairs (VA) is issuing this interim final rule to confirm that its health care professionals may practice their health care profession consistent with the scope and requirements of their VA employment, notwithstanding any State license, registration, certification, or other requirements that unduly interfere with their practice. Specifically, this rulemaking confirms VA’s current practice of allowing VA health care professionals to deliver health care services in a State other than the health care professional’s State of licensure, registration, certification, or other State requirement, thereby enhancing beneficiaries’ access to critical VA health care services. This rulemaking also confirms VA’s authority to establish national standards of practice for health care professionals which will standardize a health care professional’s practice in all VA medical facilities.
SOURCE: Federal Register Interim Final Rule 85 FR 71838 (Nov. 12, 2020). (Accessed Apr. 2025).
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