Lexology April 19, 2021
Reed Smith LLP

A report released this month (April 2021) by the US Department of Health and Human Services Office of Inspector General of recently audited Medicare payments for telehealth services finds that CMS paid practitioners for some telehealth claims associated with services that did not meet certain Medicare requirements around originating-site eligibility and asynchronous technology.

Aside from the report’s findings, it also offers a useful summary of Medicare’s originating-site eligibility requirements and conditions of payment for telehealth services.

Eligible originating sites are:

• in a county outside of a metropolitan statistical area (MSA)

• in a health professional shortage area (HPSA) that is either outside of an MSA or within a rural census tract, or

• an entity participating in a federal...

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