Wiki Telehealth update

If you held claims for telehealth services that are covered by waivers performed during the shutdown you can submit them. If you received denials for services covered by a waiver, you'll need to resubmit them. More information from CMS here: www.cms.gov/medicare/payment/fee-for-service-providers. A summary here https://pbn.decisionhealth.com/Blogs/Detail.aspx?id=201134

Dear AAPC Team,

We are a physician specialty office and want to know if we can perform telehealth services to Medicare patients.
I called Medicare today to confirm if telehealth services are covered and the rep said it is covered and directed me to this article
https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00027460
I couldn't fully understand if telehealth services are covered, and if covered, is it also covered after 1/31/26?
It talks about originating site. Does it say the patient cannot be in their home while receiving telehealth services.
It also says "For physician and practitioner offices, the only payable setting for originating site is office, place of service (POS) 11, and the payment amount is the lesser of 80% of the actual charge or 80% of the originating site facility fee, regardless of geographic location." Can you please explain this also? Thank you.

Hi, the linked document means that you can perform telehealth services as allowed by CMS' telehealth waivers through Jan. 30. For example, the patient can live in an urban area and receive telehealth services at home. On Jan. 31 the geographic restrictions, originating site requirements and so on of normal telehealth rules will go back into effect. That means the patient must be in a rural area or HPSA and go to an originating site for services, unless they meet an exception (or unless Congress extends the waivers again).