New CMS Waivers Eliminate ‘All Barriers’ to Telehealth in Skilled Nursing Facilities

As part of a sweeping set of waivers announced late Monday, the Centers for Medicare & Medicaid Services (CMS) expanded its efforts to cut restrictions on telehealth — essentially removing any last roadblock that providers would face to offering virtual interventions at nursing homes.

By allowing providers to perform initial and discharge services remotely, and by waiving a requirement that telehealth visits in skilled nursing visits occur only every 30 days, CMS succeeded in “essentially eliminating all barriers and adding services in other sites of care to the telehealth list,” according to a Tuesday statement from AMDA, the Society for Post-Acute and Long-Term Care Medicine.

Crucially, those waivers will be retroactive to March 1, so providers can bill for any such services that they may have provided at any point this month.


“The Society has long advocated for the once-a-month restriction on subsequent care codes 99307-99310 to be eliminated, and we have been particularly vocal about it in light of the COVID-19 pandemic,” AMDA executive director Christopher Laxton said in a statement, referring to the specific billing codes related to SNF telehealth services. “We are pleased that CMS has listened to our concerns and removed this barrier and others. It will provide greater access to care, and significantly safer care, for clinicians and their patients during this trying time.”

The sweeping action also brought expanded telehealth coverage to a variety of other post-acute care settings, including home health and hospice, with the overall goal of reducing face-to-face interactions during the ongoing COVID-19 crisis.

CMS has already taken several steps to relax telehealth restrictions on an emergency basis throughout the coronavirus pandemic — most notably on March 17, when the agency removed a requirement that only residents of rural nursing homes could receive virtual interventions.


At the same time, CMS also directed the Department of Health and Human Services (HHS) to temporarily halt all enforcement of HIPAA rules governing the types of programs that providers can use to communicate with patients, opening the door for consultations over common consumer platforms such as Skype and FaceTime.

Dr. Arif Nazir, AMDA’s president and chief medical officer for skilled nursing operator Signature HealthCARE, told SNN earlier this month that the foundational emergency changes that the government has implemented will leave a permanent mark on the industry.

“I do agree a new era of health care is upon us,” Nazir said on the most recent episode of SNN’s “Rethink” podcast. “I really do not believe that many of these things will be reverted back, and they don’t need to be reverted back.”

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