The Centers for Medicare and Medicaid Services (“CMS”) confirmed that hospice physicians and nurse practitioners who serve as a patient’s attending physician (“NPs”) can use telehealth to perform medically necessary visits during the COVID-19 pandemic. To assist hospices in evaluating the feasibility of using telehealth for medically necessary visits with Medicare patients, Husch Blackwell has created a “Hospice Telehealth Flowchart.” The Flowchart addresses important operational considerations as well as the Medicare requirements related to rendering and billing for such telehealth visits.

CMS’s pronouncement that Medicare will pay for medically necessary hospice physician and NP telehealth visits does not change what hospice physician and NP services are billable, but rather clarifies that such services now can be performed via audio and visual, two-way, real-time telehealth technologies. Pursuant to 42 C.F.R. § 418.304, only non-administrative, direct patient care services provided by a hospice physician or NP may be billed to Medicare, and only when:  (i) the services are reasonable and medically necessary for the palliation and management of a Medicare hospice patient’s terminal prognosis or related conditions and (ii) the physician or NP is employed by or under arrangement with the hospice (“Billable Physician/NP Visit”).

Husch Blackwell’s “Hospice Telehealth Flowchart” outlines, in a step-by-step format, the specific Medicare requirements and some operational best practices for hospices that are considering using telehealth to perform Billable Physician/NP Visits with Medicare hospice patients during the COVID-19 pandemic. The Flowchart can assist hospices in assessing whether telehealth Billable Physician/NP Visits are viable from a business and clinical perspective, and if so, for which hospice patients telehealth visits may be appropriate and feasible.

The Husch Blackwell Hospice Team are problem-solvers, and we are here to provide you with support, guidance, ideas, and strategies in the face of this unprecedented pandemic. If you are having challenges with facility access issues or any other issue related to the coronavirus, please let us advocate for you, develop materials to help you trouble-shoot, or otherwise be of assistance to you. We are here to serve.