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New Bill Aims to Ensure Medicare Coverage for Audio-Only Telehealth Calls

The bill would establish Medicare reimbursement for audio-only telehealth services that focus on evaluation and management and mental and behavioral health care, and would allow coverage for services in the patient's home.

mHealth reimbursement

Source: ThinkStock

By Eric Wicklund

- A new bill before Congress aims to expand Medicare coverage for audio-only phone calls in telehealth programs.

The Permanency for Audio-Only Telehealth Act, introduced last week by US Reps. Jason Smith (R-MO) and Tony Cardenas (D-CA), would have the Centers for Medicare & Medicaid Services reimburse care providers who use audio-only platforms for evaluation and management services as well as mental and behavioral health services. It would also remove CMS’ geographic restriction on the patient’s home as a delivery site for audio-only telehealth, and give the Health and Human Services Secretary that ability to add services for audio-only telehealth coverage.

The bill targets a popular modality that, up until the coronavirus pandemic, had been mostly off-limits for providers in care delivery. But with COVID-19 reducing in-person care and pushing more services into the connected health space, both providers and consumers have been using the audio-only phone for certain care needs.

It also addresses a few barriers to care in underserved communities and regions:  the lack of adequate broadband connectivity to support audio-visual telemedicine technology, and a lack of resources to afford those telehealth tools.

“One of the lasting impacts of the Coronavirus pandemic is the rapid expansion and increase in the utilization of telehealth services.” Smith said in a press release. “For rural and underserved areas who struggle with access to broadband and technology, none have had a greater impact than audio-only telehealth visits.”

CMS and many states have relaxed the rules during the pandemic to expand access to telehealth, including through audio-only phones, though those emergency measures will expire when the public health emergency ends.

Some of the more than a dozen telehealth bills now before Congress include provisions for permanent coverage of audio-only phone calls, especially in telemental health programs. Opponents, meanwhile, have argued that the phone call isn’t a proper platform for establishing the doctor-patient relationship, and have argued that phone calls should only be allowed in limited circumstances and after an in-person exam.

The bill has the support of a handful of groups, including the American Psychological Association.

"Allowing patients to receive mental health services by audio-only telephone is a matter of health equity for underserved populations, and APA applauds this important equalizer,” APA CEO Arthur Evans Jr., PhD, said in the press release. “This bill will allow patients to receive services at home no matter where they live − whether in rural, urban or suburban communities.”

“Nearly one-third of all Medicare telehealth visits during the current pandemic have been delivered by audio-only telephone,” added Americans for Prosperity. “Audio-only access is essential, especially for lower-income households, and should be a permanent feature of modern medicine alongside other forms of telehealth, including store-and-forward and remote monitoring tools.”

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