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4 Facts You Should Know About the CMS Telehealth Coverage Expansion

According to the American Telemedicine Association website, it states the legislation ''extends coverage for telemedicine services to millions of Medicare beneficiaries'' and ''for the first time, telehealth coverage will be extended to 80 percent of Medicare beneficiaries living in metropolitan areas and from any service originating site, such as their home''. This is all truly exciting, but what is important for everyone to know is:

  • There is no coverage for telehealth services for nursing homes and other medical facilities in metro areas unless it is part of an Accountable Care Organization (ACO)
  • Just because you are an Accountable Care Organization (ACO) does not mean that you are ready to start telehealth consultations and get reimbursed
  • ACO's must apply for the program (Next Generation ACO Model) on the CMS website, be reviewed, and if approved, then the ACO is ready to launch (the ATA did not mention how long this process could take though)
  • There is a window of time that an ACO has to apply, so move fast!

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