CMS Expands COVID Testing, Healthcare Capacity in Wake of the Pandemic

More services will now be covered by the Centers for Medicare & Medicaid Services.

Healthcare providers will have more flexibility when it comes to testing for the coronavirus disease 2019 (COVID-19), telehealth, and more, thanks to the second Interim Final Rule recently released by the Centers for Medicare & Medicaid Services (CMS).

The rule, which was released on April 30, expands access to telehealth, COVID-19 and COVID-19 antibody testing, and healthcare workforce and resources.

Telehealth

After many stakeholders — including the American Society of Clinical Oncology (ASCO) – requested improved access, CMS is increasing payments for evaluation and management conducted over the telephone. Now, they will match payment for similar office/outpatient visits for a range of about $46-$110. Payments are retroactive to March 1, 2020.

Additionally, patients in opioid treatment programs will also be able to have their periodic assessments via telehealth.

“During the [public health emergency], CMS will update the Telehealth code list on a sub-regulatory basis instead of through the formal rulemaking process — which the agency considering requests from providers now learning to use telehealth as broadly as possible,” ASCO said in a release about the rule.

COVID-19 and Antibody Testing

Since many patients with cancer already have compromised immune systems, they likely are concerned with contracting the coronavirus. Now those under CMS will no longer need a provider’s order to have the COVID-19 test covered.

CMS will also cover laboratory processing of certain FDA-authorized tests that will allow patients to self-collect at home, avoiding a clinic visit.

“Recognizing the urgency of this situation, and understanding that some pre-existing CMS rules may inhibit innovative uses of technology and capacity that might otherwise be effective in the efforts to mitigate the impact of the pandemic on beneficiaries and the American public, we are amending several CMS policies and regulations in response to the COVID-19 PHE and recent legislation, as outlined in this IFC,” the rule states.

Boosting the Healthcare Workforce

While there is still debate on home healthcare and the oncology services that should be conducted outside of a healthcare institution, CMS will now allow nurse practitioners, clinical nurse specialists, and physician assistants to provide these services. They will also provide coverage for psychotherapy, patient education, and group psychotherapy to happen in patients’ homes.

The rule also elaborates that CMS will not reduce Medicare payments to teaching hospitals that move their residents to other hospitals to help with COVID-19 treatment, and they will not penalize hospitals without teaching programs that accept these residents.

“In this extraordinary circumstance, we recognize that the COVID-19 pandemic greatly increases the overall risk to public health,” the rule says. “We believe that this increased risk results in an immediate change, not only in the circumstances under which services can safely occur, but also in to the business relationships among providers, suppliers, and practitioners.”