The Center for Medicare and Medicaid Services (CMS) finalized its CY 2021 rules for Home Health including making permanent several temporary changes that were enacted in response to COVID-19. In response to the pandemic, CMS had temporarily allowed in Interim Final Rule CMS-5531-IFC:
Home health agencies (HHA) to use telecommunication systems in conjunction with in-person visits. The use of technology must be included in the patient’s plan of care.
HHAs to report the costs of telehealth as allowable administrative costs on line 5 of the HHA cost report.
In the final rule decision, CMS is proposing to make permanent for CY 2021:
Allow HHAs to use remote patient monitoring (RPM) or other services furnished via a telecommunications system or audio-only but they must be included in the plan of care and cannot be substituted for or considered a home visit for purposes of eligibility or payment.
The use of the telecommunications technology (including audio-only) must be tied to a patient-specific need identified in the comprehensive assessment, but what is not required is a description of how the technology will help achieve the goals outlined in the patient’s plan of care. But documentation of how such technological services will/are being used to achieve the goals should be in the medical record.
Telecommunications technology may be considered allowable administrative costs on the home health reports.
CMS also noted several other points in their final rule:
Stakeholders were reminded that access to telecommunications technology must be accessible to patients, including patients with disabilities.
There is a reiteration that services provided by telecommunications technology are services that could also be provided through an in-person visit. If the service cannot be provided by technology, such as service that requires hands out interaction with the patient, the HHA must do an in-person visit.
The patient has the right to refuse services via telecommunications technology and must not be discriminated against for this. Services in these cases must be provided in-person.
For more information read the final rule in its entirety.