Top 4 Telehealth Trends in Medicare for 2021

Telehealth trends are very much outspoken in the recent times. It has built a special place in the healthcare industry as it has connected healthcare professionals and patients virtually without effecting the business. Post Covid-19 is expected to bring lot of opportunities especially in telehealth or telemedicine. The Centers for Medicare and Medicaid Services- CMS has just revealed final rule of 2021.

The final rule includes telehealth policy changes adding a new list of covered services under Medicare. During pandemic, CMS has released telehealth innovation on which few changes are being permanent. Compared to previous years, CMS made very minor changes and additions in telehealth services. Telehealth trends 2021 are expected to be bold and deliberate in order to expand telehealth services among Medicare beneficiaries.

Let’s discuss on new telehealth trends and changes in Medicare policies which greatly impacts the provision of telehealth services.

  1. Telehealth and direct supervision
  2. Extended Audio Assessment Services
  3. New Frequency limitations for Telehealth in Nursing
  4. Telehealth Codes 2021


1.Telehealth and Direct Supervision:

  • Telehealth trends 2021 reveals that until the end of next year, direct supervision under 42 C.F.R & 410.21 is provided by using real time and very interactive audio and video technology.
  • The present representation of direct supervision can be conveyed as it requires healthcare professionals who are physically present and available at any point of time immediately.
  • The assistance must be furnished throughout the performance of the procedure without fail. Direct supervision can also be considered when healthcare professionals are immediately available in an emergency and can interact with audio and video.
  • The above change doesn’t require any physician’s real time observation through audio and video technology of the performance and procedure.
  • Only audio is not sufficient to fulfill those direct supervision requirements or needs.
  • Telehealth trends 2021 open opportunities for telehealth as well as incident to telehealth billing. CMS found that there are no Medicare regulations which can explicit and prohibit eligible distant site healthcare professionals from billing for their telehealth services.
  • It was not easy for healthcare professionals and medical billers to fulfill the direct supervision telehealth services insist to their professional services.
  • Telehealth trends in clarity to the new definition stated that CMS has declared services those are provided incident to can also be provided through telehealth inside to distant site professional services under direct supervision of medical billers through technology.
  • The change is not permanent and is time limited as The Centers for Medicare and Medicaid Services thinks that virtual presence would be unsafe for some medical practices or procedures.
  • CMS will ensure collecting the data and change can be permanent even after PHE expires.

2.Extended Audio Assessment Services:

  • Telehealth trends 2021 has brought us interesting facts on which CMS has created HCPCS code G2252 especially for extended services that’s delivered through telecommunications involving only audio.
  • It’s considered for telecommunications technology based services and also the stands as subject to all the other requirements of CTBS.
  • G2252 is replaced with 99442 revenue reimbursements by making higher than the present duration virtual check in code.
  • The above code is specifically for the phenomenon where the acuity of patient’s situation or problem is not likely to warrant an in person visit.
  • G2252 also can be used in regardless of patient’s geographic location and if PHE ends before the end of CY2021.
  • It’s up to CMS decision whether to consider or decide to make interim policy permanent.

3.New Frequency Limitations for Telehealth in Nursing:

  • Telehealth trends states that The Centers for Medicare and Medicaid Services is trying or making attempts to reduce the frequency limitations for subsequent nursing facility coverage via telehealth once in a month or once in 14 days.
  • It was because of complexities and acuity of nursing facility residents in order to ensure if they have witnesses’ frequent encounters along with their healthcare professionals.
  • Telehealth is considered to me more essential and crucial to maintain continuous care in nursing facility, and if they are necessary for each specific resident.
  • Already, frequency limitations have been waived off for the duration of PHE and the new rule is coming in to force from next January.

4.Telehealth Codes 2021:

  • The following codes will be available from January 2021 permanently covered under Medicare telehealth services.
  • G2211: Visit Complexity Associated with Certain Office/Outpatient E/Ms –

This code is used for Visit complexity inherent to evaluation and management associated with medical care services which serves as the continuous focal point for all required health care services and/or with medical services that are part of ongoing care related to a patient’s single, serious condition or a complex condition.

  • G2212: Prolonged Services

This code is used for Prolonged office or other outpatient evaluation and management services beyond the maximum required time of the primary procedure that has been selected using total time on the date of the primary service in each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient interaction.

  • 90853: Group Psychotherapy-

This code is used for group psychotherapy.

  • 96121: Neurobehavioral Status Exam-

This code is used for neurobehavioral status exam.

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