Just Released! Proposed CY 2026 Medicare Physician Fee Schedule

On July 14, 2025 the unpublished version of the the Centers for Medicare and Medicaid Services (CMS) 2026 Physician Fee Schedule (PFS) was released (the official version was subsequently published in the Federal Register).

The PFS is the channel that CMS uses to update, change, or introduce new policies that will impact the Medicare program and typically go into effect on the first of the new year. The telehealth community is interested to see if a similar approach will be taken that was used for the 2025 PFS, where several policies were introduced as a precautionary measure to mitigate the potential effects of an expiration to the temporary Medicare telehealth waivers.

Our friends at the CCHP released a newly created factsheet containing a more detailed analysis of the telehealth elements within the proposed 2026 PFS. View the full PFS here and the CCHP Fact Sheet by clicking the link through the button below!

CCHP Fact Sheet of Proposed CY 2026 Medicare Physician Fee Schedule

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HIPAA and Telehealth

All platforms and programs must now be HIPAA compliant. Enforcement and penalties have resumed. During the PHE, lesser encrypted platforms (e.g. Skype, Facetime) were allowed. Now, all telehealth services (including audio only) will need to be provided using HIPAA compliant platforms. You can read more here: https://www.hhs.gov/hipaa/for-professionals/special-topics/hipaa-covid19/index.html

Medicare and Telehealth

Centers for Medicaid and Medicare Services (CMS) extended many Medicare PHE services of telehealth through December 2024, such as:

• People with Medicare can access telehealth services in any geographic area in the United States, rather than only those in rural areas.
• People with Medicare can stay in their homes for telehealth visits that Medicare pays for rather than traveling to a health care facility.
• Certain telehealth visits can be delivered audio-only (such as a telephone) if someone is unable to use both audio and video, such as a smartphone or computer.

The expanded evaluation and management codes Medicare allowed to be provided without supervision under the primary care exception ended May 11.

Additionally, after December 31, 2024, when these flexibilities expire, some Accountable Care Organizations (ACOs) may offer telehealth services that allow doctors and other practitioners participating in the ACO to care for patients without an in-person visit, no matter where they live. If a health care provider participates in an ACO, individuals should check with them to see what telehealth services may be available.

View the list of all covered CMS telehealth services here: https://www.cms.gov/medicare/medicare-general-information/telehealth/telehealth-codes

Medicaid, CHIP, and Telehealth
Medicaid and the Children’s Health Insurance Program (CHIP) telehealth flexibilities vary by state: some are tied to the end of the COVID-19 PHE, some are tied to state PHEs and other state emergency declarations, and some had been offered by state Medicaid and CHIP programs long before the pandemic. Post-PHE, Medicaid and CHIP telehealth policies will continue to vary by state. Here are some Medicaid resources for each state in our region that may be useful:

Arkansas:

https://humanservices.arkansas.gov/covid-19/dhs-response-to-covid-19/updates-for-providers/changes-to-medicaid-ending-effective-december-31-2022/

Mississippi:

https://medicaid.ms.gov/preparing-for-the-covid-19-public-health-emergency-unwinding/

https://medicaid.ms.gov/late-breaking-news/

https://medicaid.ms.gov/wp-content/uploads/2023/04/DOM-UP-Plan_March-2023.pdf 

Tennessee:

https://www.tn.gov/tenncare/information-statistics/unwinding-the-phe-for-partners.html

https://www.tn.gov/content/dam/tn/finance/fa-benefits/documents/coronavirus_benefits_info_03_31_23.pdf.pdf

Private Health Insurance and Telehealth
Private health insurance coverage for telehealth and other remote care services vary by private insurance plan and by post- PHE. When it covers telehealth and other remote care services, private insurers may impose cost-sharing, prior authorization, or other forms of medical management on such services. For additional information on an insurer’s approach to telehealth, patients should contact their insurer’s customer service number located on the back of their insurance card.

Drug Enforcement Administration (DEA) Rules and Telemedicine Prescribing
The DEA and SAMHSA have issued a temporary rule extending the controlled substance telemedicine flexibilities through November 11, 2023. Further, practitioners who have established relationships with patients via telemedicine on or before November 11, 2023, may continue prescribing controlled medications to these patients without conducting an in-person medical evaluation regardless of the practitioner being/not being registered with DEA in the state in which the patient is located until November 11, 2024. The DEA and SAMHSA plan to issue final rules by November 11, 2023.

Read more here: https://www.samhsa.gov/newsroom/press-announcements/20230509/dea-extend-covid19-telemedicine-flexibilities-prescribing-controlled-medications

The NCTRC have a huge collection of “End of PHE” resources. You can view them here: https://telehealthresourcecenter.org/collections/end-of-the-public-health-emergency/

Sources:

https://www.aafp.org/pubs/fpm/blogs/inpractice/entry/covid-phe-end.html

https://www.cms.gov/newsroom/fact-sheets/cms-waivers-flexibilities-and-transition-forward-covid-19-public-health-emergency

https://www.hhs.gov/about/news/2023/05/10/hhs-fact-sheet-telehealth-flexibilities-resources-covid-19-public-health-emergency.html

https://www.hhs.gov/about/news/2023/05/10/hhs-fact-sheet-telehealth-flexibilities-resources-covid-19-public-health-emergency.html

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Three years after the PHE was first declared (Jan. 31, 2020), all signs point to it coming to an end April 2023. What next? A great resource for preparing for the end of the PHE was developed by the NCTRC and the Office of Telemedicine Johns Hopkins Medicine. You can view it HERE.

Some things to keep in mind… with the PHE expiring in April, there will be a 151 day telehealth flexibility extension that will be in place until September 2023 (see Budget Act of 2022 below). One of the most important things to consider will be the requirement to have a HIPAA compliant telehealth video platform in place by the end of the PHE. During the pandemic, the Office for Civil Rights (OCR) allowed for lesser encrypted platforms to be utilized by not imposing penalties. Per the OCR regarding HIPAA and telehealth: “OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.” You can read more about the OCR’s pandemic discretion HERE.

Everyone will be required to have HIPAA compliant video platforms in place at the end of the PHE. It’s important to do your research and ensure your existing platform is HIPAA compliant and/or find one that is. The NCTRC has a great resource for telehealth HIPAA compliance. You can view it HERE.

Other considerations and things to know:

Consolidated Appropriations Act of 2021 expanded telehealth policy to permanently allow mental health services under certain conditions.

Budget Act of 2022 allows for certain temporary waivers to continue to be used 151 days after the end of the PHE.

• Audio only services
• Geographic limitations (i.e. home still allowed)
• FQHC, RHC, PT, OT, SLP remain eligible providers

As far as what happens when the 151 day grace period ends, our friends at the CCHP developed this chart:

Here are some great videos to watch to stay informed:

• Telehealth Policy Landscape Looking Towards 2023
• Fall 2022 CCHP telehealth update webinars overview 

It’s important to keep the conversation going. Feel free to reach out if you have any questions, ideas or concerns. Stay safe out there.

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The $14 billion Affordable Connectivity Program (formerly known as the Emergency Broadband Benefit) provides a discount of up to $30 per month toward broadband service for eligible households and up to $75 per month for qualifying households on qualifying Tribal lands.  The benefit also provides up to a $100 per household discount toward a one-time purchase of a computer, laptop, or tablet if the household contributes more than $10 and less than $50 toward the purchase through a participating broadband provider.

A household is eligible if one member of the household meets at least one of the criteria below:

• Has an income that is at or below 200% of the Federal Poverty Guidelines;
• Participates in certain assistance programs, such as SNAP, Medicaid, Federal Public Housing Assistance, SSI, WIC, or Lifeline;
• Participates in one of several Tribal specific programs, such as Bureau of Indian Affairs General Assistance, Tribal Head Start (only households meeting the relevant income qualifying standard) Tribal TANF, or Food Distribution Program on Indian Reservations;
• Is approved to receive benefits under the free and reduced-price school lunch program or the school breakfast program, including through the USDA Community Eligibility Provision;
• Received a Federal Pell Grant during the current award year; or
• Meets the eligibility criteria for a participating broadband provider’s existing low-income program.

Affordable Connectivity Program enrollment opened on December 31, 2021. Eligible households can enroll through a participating broadband provider or by (1) going to ACPBenefit.org to submit an online application or print a mail-in application and (2) contacting their preferred participating broadband provider and selecting a plan.  Additional information about the Emergency Broadband Benefit is available at www.fcc.gov/ACP, or by calling 877-384-2575 between 9 a.m. and 9 p.m. ET any day of the week.

Web Resources

• Consumer FAQ – Questions and answers on eligibility, how to apply, participating service providers, connected device benefits, Tribal benefits, and more.
• Participating Providers Look Up Tool – Find internet service providers offering the Affordable Connectivity Program discount in your state or territory.
• Affordable Connectivity Program Consumer Information
• ACPBenefit.org – The website where consumers will be able to enroll.
• Submit an ACP Complaint – File an informal consumer complaint against your provider involving the ACP.

Past blogs:

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• Improve the patient experience of care (including quality and satisfaction);
• Improve the health of populations;
• Reduce the per capita cost of health care; and
• Improve provider satisfaction (professional wellness)

The Office of Interprofessional Education (OIPE) was initiated in 2012.  The OIPE strategic plan is grounded on the Interprofessional Education Collaborative (IPEC) domains of competency for interprofessional education (IPE) and interprofessional collaborative practice (IPCP): Values & Ethics, Roles & Responsibilities, Interprofessional Effective Communication, Teams & Teamwork.  In addition to the IPEC domains, OIPE embraces the Quadruple Aim goals to guide the design and implementation of educational content in the UAMS IPE Curriculum Framework.  A horizontal organizational structure that bridges across the five health professions colleges and graduate schools at UAMS guides curriculum expectations for students and integrates IPE and IPCP goals with the clinical delivery system and our research enterprise.

One educational activity in the UAMS IPE Curriculum Framework is Quadruple Aim Project Proposal Workshop. In this workshop, interprofessional teams of students develop a mini-grant/quality improvement application targeting a call for proposals from academic or clinical care settings. In the fall of 2020, telehealth was integrated into the workshop curriculum for the first time with a little help from the South Central Telehealth Resource Center (SCTRC).

At the onset of the pandemic, Dr. Kathryn Neill, Director of Interprofessional Administrative and Curricular Affairs, was working closely with Dr. Joseph Sanford, Director of the UAMS Institute for Digital Health & Innovation (IDHI), at the UAMS Emergency Operation Center on several patient care projects. At the same time, Neill was transitioning IPE activities to things that would work virtually. Meanwhile, telehealth saw a huge explosion in response to the pandemic. All this was happening “right smack in the middle of COVID,” Neill said, “and with COVID transitions, and how we were adapting practice…telehealth just fit beautifully with what I was doing with interprofessional education.” She told Sanford, “I’d love to do some telehealth activities,” so he put her in touch with the IDHI Director of Education, Dr. Stanley Ellis, who then reached out to the SCTRC.

In November 2020, the SCTRC and other IDHI representatives took part in the workshop as content experts for students and their project development/presentation of ideas. Having telehealth experts on hand was key to the success of these events. “I see you as being experts on the different types of things that we do in digital health,” said Dr. Neill, “Absolutely rural care provision is essential, and I know there are efforts to integrate with the regional program sites.” Dr. Neill saw the content experts as a way to introduce students to the topic of telehealth, but also guide them through the intricacies of a telehealth appointment. “I think it is common that many of the students have not yet participated in a virtual visit or telehealth visit, you know – how you define it… There are different ways that you can look at it, and I think sometimes, for people that are starting new to telehealth, much of the focus is really on the logistics of it.”

During the first workshop, over the course of the afternoon (five hours total), interprofessional student teams determined an area of focus and put together a three-page written summary of their proposal using proposal worksheet guidelines with guidance from the SCTRC and other faculty facilitators.  During the last hour of the workshop, each team presented their idea to the other teams and faculty facilitators for Q&A and feedback. Since then, the SCTRC has participated in two other workshops, most recently in September 2021.

Dr. Neill has a vision for the future of the program and SCTRC’s place in it. She wants digital health and Interprofessional Education to have a continued strong link. “It’s the way things are moving forward,” says Neill. “I want us to strategically think about what do we do next… Or how do we use the things we’re doing right now and put them out there in a different way – to really grow our telehealth presence and recognition in the state.” After reviewing several competencies (i.e. IPEC, AAMC, and the IDHI) and co-mapping all proficiencies, Dr. Neill says, “It’s really easy to say how working interprofessionally helps us with patient care and team collaboration and using telehealth as the venue to be able to do that opens up tremendous opportunities.”

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What is monoclonal antibody treatment?

The U.S. Food and Drug Administration (FDA) approved monoclonal antibody treatment for emergency use against COVID-19. Contrary to the initial antibody treatment introduced at the beginning of the pandemic, through convalescent plasma infusions, monoclonal antibody treatment is laboratory-made antibodies and not antibodies produced from other persons that previously had the coronavirus. This treatment does not contain any live SARS-CoV-2 (the virus that causes COVID-19)¹. It does serve to reduce the amount of SARS-CoV-2 in the body and provides the body a boost to produce more antibodies.

Who should receive this type of treatment?

Patients testing positive for COVID-19 with symptoms for 10 days or less, especially those at higher risk for hospitalization, treatment may help. In addition, the FDA has authorized the use of this treatment, for emergency use, on those exposed to COVID-19 that are immunosuppressed.

Below are a few risk factors that could increase your risk for hospitalization if you get covid-19:

• Body Mass Index of 25 or greater
• Pregnancy
• Underlying health conditions (heart disease, diabetes, sickle cell disease, chronic kidney disease, etc.)
• Immunosuppressive diseases

“While the battle against the coronavirus pandemic continues, HealthNow’s digital platform offers virtual visits allowing patients across the state of Arkansas to receive assistance with treatment. HealthNow’s nurse practitioners are working tirelessly to provide Arkansas patients with educational and emotional support through this COVID-19 health crisis.”

For more information on HealthNow, please visit: https://uamshealth.com/healthnow/

For more information on monoclonal antibody treatment, please visit: https://combatcovid.hhs.gov/i-have-covid-19-now/monoclonal-antibodies-high-risk-covid-19-positive-patients

Sources:

1. Assistant Secretary for Public Affairs (ASPA). Monoclonal antibodies for high-risk COVID-19 positive patients. combatCOVID.hhs.gov. https://combatcovid.hhs.gov/i-have-covid-19-now/monoclonal-antibodies-high-risk-covid-19-positive-patients. Published August 9, 2021. Accessed August 10, 2021.

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Consumers Can Enroll Beginning May 12th!

The new Emergency Broadband Benefit program lowers the cost of high-speed internet service to ensure people have the connectivity they need during the ongoing COVID-19 public health emergency. This program is supported by the FCC and hosted by USAC.

Consumers

Eligible patients and households may apply in three ways: 

1. Contact your preferred participating broadband provider directly to learn about their application process.
2. Go to or apply online to find participating providers near you.
3. Call 833-511-0311 for a mail-in application, and return it along with proof of eligibility to:
   Emergency Broadband Support Center, P.O. Box 7081, London, KY 40742

Health centers and organizations are encouraged to increase awareness and help patients apply (e.g., outreach, internet access, and supporting application completion).

Patients and Consumers may learn more about the program, household eligibility factors, participation requirements, etc., via these two resources:

• USAC webpage, Emergency Broadband Benefit Program
• FCC Consumer FAQ

USAC has created a website specifically for Consumers at getemergencybroadband.org.

About the program

The Federal Communications Commission’s (FCC) Emergency Broadband Benefit (EBB) program includes $3.2 billion in funding that will be available to provide qualifying households discounts on their internet service bills and an opportunity to receive a discount on a computer or tablet. The EBB program is similar to the Lifeline program with expanded eligibility, internet vendors, and subsidies. This benefit is available directly to consumers on a first-come, first-serve basis.

Providers

Service providers can visit the FCC’s EBB webpage or Fact sheet to learn more.

Visit the FCC’s EBB Providers page to view a list of broadband providers in each state who have elected to participate in the Emergency Broadband Benefit Program. The list will be updated as providers join the program.

Providers: Arkansas | Mississippi | Tennessee

The National Verifier staging environment can be found at https://nationalverifiertraining.servicenowservices.com/lifeline. To access the staging environment for NLAD, please log into USAC’s OnePortal and select “NLAD.”

For information about using the staging environments – including test data providers can use – please visit the NLAD staging page and National Verifier staging page on USAC’s website.

Materials that partners can use to help promote the Emergency Broadband Benefit to the communities they serve will be available soon on www.fcc.gov/emergency-broadband-benefit-outreach-toolkit.

The FCC hosted a webinar that provided an overview of the benefit, eligibility criteria, how to apply, and the FCC’s partner toolkit materials. If you missed the event, a recording can be viewed online. 

Updated: 05.11.2021

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So what does remote/virtual health and P.E. look like? It’s all about “creative strategies,” says Walters. “Health and P.E. are suffering right now in the pandemic, but it’s more important than ever” and she’s doing her best to support health and PE teachers so they can provide quality health and physical education instruction to their students, whether that’s in-person, virtual or a mix of the two. She assists these professionals remotely by providing training and resources that support standards-based instruction.

Audra will be assisting the SCTRC with our Telehealth Round Up webinar series early in 2021.

The post K through 12 Health and Physical Education in the Time of COVID19 appeared first on LearnTelehealth.

Dr. Leslie Morland continued to push the event pass the starting line with her plenary talk, Virtual Mental Health Care in the Veterans Health Administration: An Immediate Response to COVID-19, which was all the more pertinent since it was Veteran’s Day. Morland acknowledged that with all the rapid changes due to the Public Health Emergency and the rush to telehealth, there was “no going back” when it comes to technology in healthcare. Since the pandemic, through evaluation and with an 11-fold increase in video visits and a 5-fold increase in phone visits by June of this year, the VA discovered their clients felt little to no difference between video visits versus in person visits. Phone only visits are just as comparable due to the overall simplicity versus using a smart device. In closing, Morland declared that “teletherapy is very much going to outlive this pandemic.”

After the plenary talk, the poster session began with an array of interesting and worthy research topics: Teledermatology triage cost savings in urban settings; Clinical telehealth vs telehealth as a health delivery system tool; Bedside telemedicine during a pandemic; Opioid treatment; Reducing NICU stay; and Evaluating telehealth access disparities at a pediatric clinic during the pandemic.

The last scheduled presentation of the day was a panel, Social Determinants and Health Equity in Telehealth: A Fireside Chat, with Dr. Kenny Kronforst, Jennie Joseph, and Dr. Jennifer Reneker. Dr. Kronforst opened by outlining steps that were taken in Illinois during the early days of the pandemic and the deluge of data that came from the virtual-sphere. In response to this and to make the most of it, the Telehealth Datamart program was created to synthesize and validate the data. The preliminary data showed a lower percent of completed visits among non-English speakers and lower video visits among Latinx patients. Next steps include mapping to other indexes and surveying providers and parents. Kronfrost was followed by Jennie Joseph, a midwife who’s worked with high risk mothers to bridge the gap of maternal morbidity. Her vision is that all women have access, connections, knowledge, and empowerment, “building a movement to birth a more just and loving world.” Maternal morbidity is much higher among black women and looking at social determinants provide relevance, but Joseph emphasized that it’s important to understand that “materno toxicity” can surface anywhere. With the shift to telehealth, Joseph was able to maintain care while also maintaining client satisfaction. Since March of this year, out of 180 women, only 2 were born pre-term. Dr. Jennifer Reneker was the last to present, and her project focused on diagnosis and treatment of concussions using virtual reality (VR). Working in Mississippi where sports are a huge part of the state’s culture, she noted the lack of state requirements for certified trainers or professionals to be present at sporting events where many others states do have such a mandate. Reneker also noted that in light of this fact, the state’s telehealth capacities were “exceptional.” In 2017, they established Heads Up Mississippi, a program to provide comprehensive prevention, diagnosis, and research. Part of this program was the development of a VR tool in order to diagnose and research concussed participants. VR can engage users through an immersive atmosphere, create novel environments, continuously measure movements (e.g. eye tracking), and analytics can be sent to a computer where a clinician can synchronously or asynchronously meet up with the patient in the VR metaverse. After their presentations, the three professionals discussed their projects and disparities at large.

The day ended with two networking tables (i.e. virtual breakout rooms), Stories from the field: pediatric telehealth challenges, success, and future directions hosted by Dr. David McSwain, and Conducting multi-site telemedicine trials research: challenges and solutions hosted by Dr. Jonathan Neufeld.

For more information about the conference or the SEARCH Society, visit here: https://searchsociety.org/

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