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Medicare payment policies during COVID-19

The Centers for Medicare & Medicaid Services has expanded coverage for telehealth services and providers during the COVID-19 public health emergency.

Telehealth policy changes

The federal government announced a series of policy changes that broaden Medicare coverage for telehealth during the COVID-19 public health emergency. Legislation was recently passed   (PDF) that gives a runway of 151 days after the end of the PHE before any policy and regulation changes take place.

Some important changes to Medicare telehealth coverage and reimbursement during this period include:

• Location: No geographic restrictions for patients or providers
• Eligible providers: All health care providers who are eligible to bill Medicare can bill for telehealth services, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)
• Eligible services: See this list of telehealth services from the Centers for Medicare & Medicaid Services
• Cost-sharing: Providers can reduce or waive patient cost-sharing (copayments and deductibles) for telehealth visits
• Licensing: Providers can furnish services outside their state of enrollment. For questions about new enrollment flexibilities, or to enroll for temporary billing privileges, use this list of Medicare Administrative Contractors (MACs) to call the hotline for your area
• Modality: The 2022 Physician Fee Schedule has codified the ability for behavior health services to do audio only. It is still required to complete an in-person appointment every 6 months.

For guidance on billing and coding Medicare claims during COVID-19, see:

• Billing and coding Medicare Fee-for-Service claims
• Billing Medicare as a safety-net provider

For details about Medicare waivers and flexibilities in effect, see:

• Medicare Coverage and Payment of Virtual Services    (video) — from the Centers for Medicare & Medicaid Services
• COVID-19 Telehealth Coverage Policies   — from the National Policy Center - Center for Connected Health Policy

For changes announced in the 2022 Physician Fee Schedule, see:

• CY22 Telehealth Update Medicare Physician Fee Schedule (PDF) — from the Centers for Medicare & Medicaid Services
• Final CY 2022 Medicare Physician Fee Schedule   (PDF) — from the National Telehealth Policy Resource Center

Have a question?

Contact the staff at the regional telehealth resource center   that’s closest to you for help with your telehealth program.