ASHA Urges Immediate Action From CMS on Pending Expiration of Telehealth Benefits in Certain Health Care Settings

Medicare Beneficiaries Risk Losing Access to Essential Therapeutic Services Tomorrow Unless the Agency Takes Immediate Action

May 12, 2023

(Rockville, MD) The termination of the COVID-19 public health emergency could have an unintended, unanticipated, and potentially catastrophic effect on some of the nation’s most vulnerable Medicare beneficiaries without immediate action from the Centers for Medicare & Medicaid Services (CMS), according to the American Speech-Language-Hearing Association (ASHA), which is sounding the alarm to CMS, its members, Medicare beneficiaries, and members of Congress.

According to the Association, by the end of this week, CMS must clarify outpatient telehealth coverage for services provided by certain health care facilities to avoid unnecessary restrictions to care for patients nationwide.

At issue is CMS’s recent interpretation of its Congressional authority to pay for outpatient telehealth services—including occupational, physical, and speech-language therapy. Despite Congressional direction to cover telehealth services through 2024, and no official written guidance from CMS suggesting otherwise, Medicare beneficiaries are nonetheless being told that telehealth services provided by hospitals, skilled nursing facilities, and rehabilitation agencies won’t be covered after May 11—the end of the federal public health emergency. Per the Medicare Payment Advisory Commission, 63% of Medicare outpatient therapy services are furnished by facility providers.

The cutoff of services could happen because CMS staff have specifically stated on two recent national calls with Association stakeholders that outpatient occupational, physical, and speech-language treatment services delivered via telehealth at such facilities will no longer be covered by Medicare. CMS has indicated that the claim form on which these services are paid for is the root of the problem because the National Provider Identifier (NPI) of the speech-language pathologist (SLP) is not placed in the form.

For weeks, ASHA—in coordination with other professional associations—has been reaching out to CMS for clarification, but no new guidance has been provided. Without it, providers cannot deliver telehealth services in these facilities to Medicare beneficiaries without risking financial liability. Patients in rural and underserved areas could be severely negatively impacted by sudden restrictions on their access to specialty services that may not be readily available in their local area.

ASHA urges CMS to reexamine their interpretation of federal law as soon as possible. A letter sent to CMS recently from the Association can be found on ASHA’s website.

Also, as part of its annual ASHA Capitol Hill Day, ASHA raised its concerns with lawmakers in more than 100 visits with members of Congress and their staff, specifically asking them to reiterate to CMS their intention to maintain access to telehealth for all Medicare beneficiaries through 2024.

About the American Speech-Language-Hearing Association (ASHA)
ASHA is the national professional, scientific, and credentialing association for 228,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids. Speech-language pathologists (SLPs) identify, assess, and treat speech, language, and swallowing disorders.

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