Medicare Monday: When does Medicare Part B coverage of telehealth therapy services end?
A: December 31, 2024
B: July 1, 2024
C: When the PHE ends
D: Medicare permanently covers telehealth for therapy services
Watch the video below for the answer!
Hey, I’m Clarice from Amplify OT and it’s time to answer another Medicare Monday about when Medicare stops paying for telehealth services under Part B for therapy. And the answer is a December 31st, 2024.
It’s now January, 2024. So if you find us later, this information may be out of date.
Initially when the public health emergency waiver was first issues, the coverage of telehealth services for OT, PT, and speech was this supposed to expire when the public health emergency expired. However, Congress did take action at one point to extend it by like 180 days.
But then Congress took action again to pass legislation to allow coverage of telehealth services. And basically the continuation of those waivers through the end of calendar year 2024.
Previous Medicare Telehealth Coverage
So prior to the COVID-19 public health emergency Medicare part B covered telehealth and pretty limited ways.
Predominantly patients had to go to a healthcare facility in order to receive telehealth services. And it was really only used for specialists and physicians, especially in rural areas where they may not have as easy access to those specialists. So one of the big changes that the public health emergency waivers did is that they actually allowed patients to receive telehealth services in their home.
So, how do we make this permanent? It has to go through Congress. Because we were technically expanding the coverage benefits of Medicare that has to go through Congress in order to officially approve that Medicare can reimburse for telehealth services specifically for therapy, as well as some of the other policies.
Now the good news is that AOTA has actually been advocating for telehealth coverage under Medicare for years, which is part of why occupational therapy was fortunately, automatically included in the telehealth legislation that passed in Congress at the end of 2022.
This is why even when we don’t see big successes in advocacy right away, it’s always a step in the right direction.
If we had not been laying the path for telehealth for years prior, we may not be in the situation we are right now.
Now one barrier to a permanent solution is that expanding coverage of services under Medicare is expensive.
Congress is going to see it as an expense, and they’re going to have to technically find a way to pay for it. Now Congress and budgets, it’s all a little gimmicky. So whether or not they actually ended up paying for it. I don’t know, but they have to find a way to make it look on paper as if they are paying for the services that they are expanding.
So basically cutting somewhere else or saving money somewhere else. In order to approve increased spending in Medicare.
And even though we, as practitioners may not necessarily feel like this is an expansion of services because we are expanding coverage of services. It is seen as an increased cost because of the increased access.
So basically more patients would probably have access to therapy than previously. So there would be more therapy services being provided, which increased the cost to the government.
Another thing that’s in our favor though, is that telehealth really is a bipartisan issue, which means both Republicans and Democrats are supportive of permanently expanding telehealth. And if you look at the different pieces of legislation that AOTA highlights on their take action page, you can see that those pieces of legislation are sponsored by individuals from both sides of the aisle.
And that bipartisan support is really important, especially when we have such a divided Congress.
Now, if I had to make a guess, we’re probably not going to see any telehealth legislation pass until somewhere towards the end of the year. Because if there’s one thing that Congress excels at it is procrastinating.
So what you can do right now in order to support permanently expanding telehealth services. Is to contact your legislators through the AOTA Take Action Page at aota.org/takeaction. It takes like five minutes to email your legislator and let them know how important telehealth is to you. And the best part is, is that AOTA already wrote most of the letter. You just have to edit it and put in your story and hit, send.
And while it seems like a small action, it really does help support the larger advocacy efforts that AOTA is able to do on our behalf, as well as other organizations.
If you think telehealth coverage should stick around, then definitely take action today.
Okay, thank you to everyone who participated in this week’s Medicare Monday, and I will see you next week.