The Public Health Emergency (PHE) has been extended until October 18, 2021, but the Biden Administration has signaled that it will be kept in place for the rest of the year. Medicare will continue to pay rehabilitation therapists for providing care via telehealth for the duration of the PHE. Outside of the waivers provided by the CARES Act, CMS cannot reimburse physical and occupational therapists for telehealth; therefore, in order to prevent retraction of coverage for telehealth, the law must be changed.
A significant number of federal lawmakers now recognize the value and importance of maintaining access to care via telehealth. Multiple bills have been introduced this Congress that could achieve payment for physical and occupational therapists who provide care to Medicare beneficiaries via telehealth. Some are narrowly tailored while others offer a wide range of policy options that lawmakers can pull from when developing comprehensive telehealth legislation that would be brought to the floor for a vote.
The CONNECT for Health Act (S.1512/H.R.2903) is a broad but conservative bill. Among the provisions which cover a wide range of telehealth applications is a part which permits the Secretary of Health and Human Services (HHS) to add providers (including rehabilitation therapists) to the list of Medicare providers that can be paid for telehealth. Unfortunately, that coverage is not permanent; instead, coverage would only last 3 years and would need to be renewed.
The Telehealth Modernization Act (S.368/H.R.1332) would also grant the Secretary of HHS the power to expand coverage for care provided via telehealth to additional provider types. From the perspective of rehabilitation therapists, this bill is better than the CONNECT for Health Act because inclusion in the list of approved provider types does not expire.
While these two bills would make it possible for physical and occupational therapists to be paid for rehabilitation care provided to Medicare beneficiaries, they don’t actually ensure that will take place. Furthermore, it is unclear how long it would take for HHS to act to include rehabilitation therapists in the list of approved provider types.
In contrast, the Expanded Telehealth Access Act (H.R.2168) seeks to permanently ensure that physical and occupational therapists will be paid for care they provide via telehealth. Unlike the other two bills, this bill would directly add physical therapists, physical therapist assistants, occupational therapists, occupational therapist assistants, and other rehabilitation therapists to the statutory list of providers that Medicare must reimburse for care provided via telehealth. Enactment of this bill would also allow for parity in payment. The companion bill in the Senate has yet to be introduced, but it is expected soon.
Stakeholders are asking Congress for a two-year extension of the COVID-era telehealth waivers. If those don’t materialize, coverage for telehealth will end when the Public Health Emergency ends—unless a law expanding and extending the policy is enacted.
A Practical Guide for Implementing Telehealth in Rehab Therapy Practices
4 steps to get started and ensure success with telehealth