AAFP Advocacy Wins With CMS Telehealth Payment Boost

Increased Payment for Audio-only Visits Is Just What Academy Sought

May 05, 2020 09:17 am News Staff

CMS on April 30 increased reimbursement rates for audio-only telemedicine, answering a significant need for physicians and patients and delivering policy the Academy had championed since the start of the COVID-19 public health emergency.

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The change(www.cms.gov) -- which is retroactive to March 1 -- boosts payments for telephonic evaluation and management services (CPT codes 99441-99443) to match those of regular, in-office E/M visits (99212-99214). Payments will increase from about $14-$41 to about $46-$110.

In a March 20 letter,(2 page PDF) the Academy and four other medical organizations advised congressional leaders that exactly this flexibility was needed to ensure care for vulnerable patient populations.

All payers, that letter said, should "provide coverage and payment for audio-only telehealth visits with patients at the same level as in-person visits."

"While virtual telehealth visits may be covered in some cases by insurers, they typically are paid far less than in-person visits and do not include traditional audio-only phone calls with patients, only video-enabled telehealth applications," it added. "Many patients, especially seniors, have access to phones but not video-enabled telehealth apps."

The AAFP's co-signatories on that correspondence were the AMA, the American College of Physicians, the American College of Surgeons and the Medical Group Management Association.

The Academy and 40 other medical and specialty groups repeated the call for audio-only telehealth payment parity in an April 8 letter(3 page PDF) to CMS Administrator Seema Verma, M.P.H.

Physicians represented by that coalition, the letter told CMS, were able to obtain from audio-only patient visits "about 90% of the information they would collect using audio- and video-capable equipment," yet they faced financial hardship due to the considerably lower E/M rates that were paid at that time for audio-only telehealth.

"Additionally, not reimbursing for telephone visits (99441-99443) -- at a payment level on par with in-person visits -- disproportionally affects physicians and practices taking care of elderly and underserved patients," the letter added.

CMS' rule further loosens restrictions on virtual care; more than 80 services can now be furnished via telehealth, as the Academy requested in a March 26 letter.(2 page PDF)

The Academy continues to update its COVID-19 telehealth page, which, along with the rest of AAFP.org's dedicated coronavirus content, is frequently revised based on the latest federal guidance.

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