CMS proposes expanded telehealth reimbursement for 2018

The proposed Medicare Physician Fee Schedule (PFS) rule would provide a boost in reimbursement to telehealth services, paying for several new services and codes.

In the 2018 proposed rule, released by CMS on July 13, would add the following codes to the list of covered telehealth services:

• CPT code 90785: Interactive complexity
• CPT codes 96160 and 96161: Health risk assessment
• CPT codes 90839 and 90840: Psychotherapy for crisis
• HCPCS code G0506: Care planning for chronic care management
• HCPCS code G0296: Visit to determine low dose computed tomography eligibility

The addition of psychotherapy and low-dose CT consultation codes were based on requests submitted to CMS by telehealth practitioners during 2016. Several more suggested additions, such as services related to physical, occupational, and speech therapy, as well as initial hospital care, were rejected.

The proposed rule continues a trend of telehealth expansion in the PFS. In the 2017 rule, new codes were added for end-stage renal disease-related services, advanced care planning, and critical care consultations. Similar additions were made in the 2016 rule. Like those changes, if the services make into the final rule, CMS would reimburse eligible telehealth providers at the same rate as if those services were delivered in an office visit.