TEXT FROM: https://www.congress.gov/bill/116th-congress/house-bill/6074/text relating
to telehealth
DIVISION B—TELEHEALTH SERVICES DURING CERTAIN
EMERGENCY PERIODS
SHORT TITLE
SEC. 101.
This division may be cited as the “Telehealth Services During Certain Emergency Periods Act of
2020”.
SECRETARIAL AUTHORITY TO TEMPORARILY WAIVE OR MODIFY
APPLICATION OF CERTAIN MEDICARE REQUIREMENTS WITH RESPECT TO
TELEHEALTH SERVICES FURNISHED DURING CERTAIN EMERGENCY
PERIODS
SEC. 102.
(a) IN GENERAL.—
(1) WAIVER AUTHORITY.—The first sentence of section 1135(b) of the Social Security
Act (42 U.S.C. 1320b–5(b)) is amended—
(A) in paragraph (6), by striking “and” at the end;
(B) in paragraph (7), by striking the period at the end and inserting “; and”; and
(C) by inserting after paragraph (7) the following new paragraph:
“(8) in the case of a telehealth service (as defined in paragraph (4)(F) of section 1834(m))
furnished in any emergency area (or portion of such an area) during any portion of any
emergency period to an individual by a qualified provider (as defined in subsection (g)(3))—
“(A) the requirements of paragraph (4)(C) of such section, except that a facility fee under
paragraph (2)(B)(i) of such section may only be paid to an originating site that is a site described
in any of subclauses (I) through (IX) of paragraph (4)(C)(ii) of such section; and
“(B) the restriction on use of a telephone described in the second sentence of section
410.78(a)(3) of title 42, Code of Federal Regulations (or a successor regulation), but only if such
telephone has audio and video capabilities that are used for two-way, real-time interactive
communication.”.
(2) DEFINITION OF QUALIFIED PROVIDER.—Section 1135(g) of the Social Security
Act (42 U.S.C. 1320b–5(g)) is amended by adding at the end the following new paragraph:
“(3) QUALIFIED PROVIDER.—The term ‘qualified provider’ means, with respect a
telehealth service (as defined in paragraph (4)(F) of section 1834(m)) furnished to an individual,
a physician or practitioner (as defined in paragraph (4)(D) or (4)(E), respectively, of such
section) who—
“(A) furnished to such individual an item or service for which payment was made under
title XVIII during the 3-year period ending on the date such telehealth service was furnished; or
“(B) is in the same practice (as determined by tax identification number) of a physician or
practitioner (as so defined) who furnished such an item or service to such individual during such
period.”.
(3) IMPLEMENTATION.—The Secretary of Health and Human Services may implement
the amendments made by this subsection by program instruction or otherwise.
(b) CLARIFICATION OF DEFINITIONS OF EMERGENCY AREA AND EMERGENCY PERIOD.—
Paragraph (1) of section 1135(g) of the Social Security Act (42 U.S.C. 1320b–5(g)) is amended
to read as follows:
“(1) EMERGENCY AREA; EMERGENCY PERIOD.—
“(A) IN GENERAL.—Subject to subparagraph (B), an ‘emergency area’ is a geographical
area in which, and an ‘emergency period’ is the period during which, there exists—
“(i) an emergency or disaster declared by the President pursuant to the National
Emergencies Act or the Robert T. Stafford Disaster Relief and Emergency Assistance Act; and
“(ii) a public health emergency declared by the Secretary pursuant to section 319 of the
Public Health Service Act.
“(B) EXCEPTION. —For purposes of subsection (b)(8), an ‘emergency area’ is a
geographical area in which, and an ‘emergency period’ is the period during which, there exists—
“(i) the public health emergency declared by the Secretary pursuant to section 319 of the
Public Health Service Act on January 31, 2020, entitled ‘Determination that a Public Health
Emergency Exists Nationwide as the Result of the 2019 Novel Coronavirus’; and
“(ii) any renewal of such declaration pursuant to such section 319.”.
CMS documents for COVID-19 reimbursement
https://www.cms.gov/files/document/03052020-medicare-covid-19-fact-sheet.pdf
https://www.cms.gov/files/document/03052020-individual-small-market-covid-19-fact-sheet.pdf
https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-
tests
