CMS Updates and Telehealth

Nurses may soon see new remote nursing jobs appearing. The Centers for Medicare and Medicaid Services (CMS) recently released their Calendar Year 2019 Physician Fee Schedule, which details the reimbursements CMS will pay to physicians for particular services. Several of the updates are likely to encourage and increase the use of telehealth, which would provide more career opportunities for nurses.

In the new fee schedule, CMS has made two significant changes: they have expanded the list of telehealth services they will reimburse as though performed in person and they have delineated some services that fall outside the boundaries of Medicare telehealth services—and therefore are subject to different restrictions and reimbursed according to different rules.

CMS reimburses for some telehealth services as though those services had been performed in person. Psychiatric diagnostic evaluations and management/prescription of medications are two services reimbursed this way. For 2019, CMS has expanded this type of reimbursement to include telehealth care of end stage renal disease (ESRD) and acute stroke patients. Some ESRD-related clinical assessments can even be performed via telehealth while the patient is at home.

In addition to this expansion, CMS has said that some situations in which a healthcare provider interacts remotely with a patient do not fall under the “as though in-person” telehealth restrictions. These interactions are not meant to substitute for an in-person visit and can now be reimbursed according to different rules. Such services include:

  1.     virtual check-ins, via video or telephone, to determine whether an in-person visit is necessary
  2.     evaluation of recorded patient information, such as pre-recorded videos or pictures
  3.     consultations between physicians

These policy changes are likely to increase use of remote health care services, which would open exciting new doors for nurses. Nurses could perform virtual check-ins and other preventive or triage-related services. Because of CMS’ updates, nurses should watch for increased demand for telehealth nurses and for new careers in telehealth and remote healthcare to develop.