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CMS Adds Reimbursement for Cardiac Rehab Services Via Telehealth

CMS has added 11 services to Medicare's telehealth reimbursement list for the duration of the pandemic and released new resources for state Medicaid and CHIP programs looking to expand their connected health offerings.

Telehealth reimbursement

Source: ThinkStock

By Eric Wicklund

- The Centers for Medicare & Medicaid Services has announced that 11 more telehealth services will qualify for Medicare reimbursement during the coronavirus pandemic.

The agency also released new resources to help Medicaid and Children’s Health Insurance Program (CHIP) programs use telehealth during the ongoing national emergency.

The added services primarily cover cardiac rehabilitation, and point to an increased interest among healthcare providers to use remote patient monitoring platforms to improve care management for cardiac care patients at home. They also nod to recent studies suggesting that patients with cardiac issues aren’t accessing routine checkups and other services during the pandemic, putting them at higher risk of a serious health issue.

“CMS is taking action to increase telehealth adoption across the country,” CMS Administrator Seema Verma said in a press release. “Medicaid patients should not be forgotten, and today’s announcement promotes telehealth for them as well. This revolutionary method of improving access to care is transforming healthcare delivery in America.”  

The new services are:

  • 93797: Cardiac rehab;
  • 93798: Cardiac rehab/monitor;
  • 93750: In-person ventricular assist device interrogation;
  • 95970: Electronic analysis of implanted neurostimulator pulse without programming;
  • 95971: Electronic analysis of implanted neurostimulator pulse generator/transmitter with programming;
  • 95972: Electronic analysis of implanted neurostimulator pulse generator/transmitter;
  • 95983: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; first 15 minutes face-to-face with physician or other qualified healthcare professional;
  • 95984: Electronic analysis of implanted neurostimulator pulse generator/transmitter, by physician or other qualified healthcare professional; with brain neurostimulator pulse generator/transmitter programming; each additional 15 minutes face-to-face with physician or other qualified healthcare professional;
  • G0422: Intensive cardiac rehab with exercise;
  • G0423: Intensive cardiac rehab, no exercise; and
  • G0424: Pulmonary rehab with exercise.

They join 135 services added to the reimbursement list since May 1, when CMS issued the Interim Final Rule to expand telehealth coverage and access to help providers deal with the COVID-19 crisis.

According to the agency, more than 12.1 million beneficiaries of Medicare fee-for-service programs, or more than 36 percent of the total population, used a telehealth service between mid-March and mid-August of 2020.

With regard to Medicaid and CHIP, CMS has released a new supplement to its State Medicaid and CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version. The updated toolkit offers new examples and advice from states that have expanded their connected health coverage during the crisis.

“It also helps states identify services that can be accessed through telehealth, which providers may deliver those services, the ways providers may use in order to deliver services through telehealth, as well as the circumstances under which telehealth can be reimbursed once the PHE expires,” the agency reported.

According to CMS, between March and June of this year, some 34.5 million services were delivered to Medicaid and CHIP beneficiaries, a 2,600 percent increase compared to the same time period in 2019.

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