With the end of the COVID-19 Public Health Emergency (PHE) on May 11, 2023, it remains unclear whether skilled nursing facility (SNF) providers will be able to continue to furnish physical therapy (PT), occupational therapy (OT), or speech-language pathology services (SLP) via telehealth under Medicare Part B when medically appropriate, as has been permitted during the PHE. Although the Centers for Medicare and Medicaid Services (CMS) has issued PHE unwinding guidance for many services, and despite multiple requests for guidance on coverage and claims processing to be issued before the end of the PHE, this has not yet occurred.
The impact is that it is unclear whether SNF providers that furnish therapy telehealth services on or after May 12, 2023, or outpatient therapy providers furnishing therapy telehealth services to assisted living residents will receive payment for such services. Until CMS issues clear guidance,
AHCA/NCAL recommends that providers contact their Medicare Administrative Contractor (MAC) for guidance on this issue and document those communications before proceeding with furnishing therapy telehealth services on or after May 12, 2023. AHCA/NCAL, along with several other organizations representing therapists and therapy providers
issued a statement for CMS and members of Congress requesting that this situation be resolved immediately.
Background Prior to the COVID-19 PHE, PT, OT, and SLP practitioners were not included in the Medicare law as being permitted to furnish telehealth services under Medicare Part B benefits. During the PHE, therapists were identified under the Section 1135 waiver provisions as practitioners that could furnish telehealth services.
Ordinarily, these waivers would end when the PHE concludes. However, Congress enacted legislation that recognizes PT, OT, and SLP clinicians as telehealth practitioners through December 31, 2024. Specifically, Section 4113 of the Consolidated Appropriations Act of 2023 (P.L. 117-328) directed CMS to extend the beneficiary access to therapy services furnished via telehealth services initiated during the PHE through the end of 2024.
To date, CMS has not provided specific guidance to ensure that Medicare beneficiaries will continue to have access to Part B therapy telehealth services when furnished by an institutional provider, such as a hospital outpatient therapy department, SNF, home health agency, or outpatient rehabilitation facility.
AHCA/NCAL continues to work with other stakeholder organizations to resolve this issue and will provide updates as they are available.