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Telehealth for All

Heading into 2022 in the third year of pandemic, there is a growing familiarity with the many changes to the delivery of healthcare that the COVID-19 virus has brought.

On January 31, 2020, the federal government declared a national Public Health Emergency (PHE) under the Public Health Service Act, which has been continually renewed every three months. The PHE has broadened access to telehealth services by extending blanket waivers for providers who deliver telehealth services to Medicare patients. With each renewal, the standing blanket waivers have increased the ease and delivery of telehealth and brought forth an increasing need to examine whether these blanket waivers should become permanent.

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These waivers have provided healthcare providers the flexibility to deliver telehealth services and care to patients using remote communication technologies like FaceTime, Zoom, or Skype. The combination of remote technology and the continuing blanket waivers during this pandemic have also allowed providers to:

Conduct telehealth visits with patients located in their homes and outside of designated rural areas;

Provide remote care through telehealth across state lines;

Deliver care to both established and new patients through telehealth; and,

Bill for telehealth services (both video and audio-only) as if they were provided in person

The public and healthcare providers were quick to adapt the use of telehealth to continue to access, deliver, and receive care during lockdowns and with limited resources at the heights of disease outbreaks. The CDC notes that there was a 154 percent increase in telehealth visits during the last week of March 2020, compared with the same period in 2019.

Several attempts are being made in Congress to ensure permanent access to and ease of delivery of telehealth services to Medicare beneficiaries. Recognizing that the PHE declaration may end soon, the latest bill to be introduced on a bipartisan basis is the Telehealth Extension Act. The legislative proposal aims to lift geographic and site restrictions to allow Medicare beneficiaries to access telehealth no matter where
they live.

The bill also incorporates recommendations from the Medicare Payment Advisory Commission (MedPAC). It would extend select COVID-19 emergency telehealth waivers for two years to permit Medicare coverage for telehealth services provided by specialty providers, including speech language pathologists, occupational therapists, and physical therapists.

This extension would allow critical access for hospitals to keep providing outpatient behavioral therapy via telehealth and would ensure proper reimbursement for audio-only telehealth services.

And while the legislation is primarily directed to assist Medicare beneficiaries, once implemented by the Center for Medicare and Medicaid Services (CMS), it is common for private insurers to follow CMS's lead on reimbursement and payment of services.   


Gabriela Villanueva is CAP’s Government and External Affairs Analyst. Questions or comments related to this article should be directed to