Allowance of certain telehealth services furnished using audio-only technology

Section 1834(m)(4) of the Social Security Act (42 U.S.C. 1395m(m)(4)) is amended by adding at the end the following new subparagraph: (G) Telecommunications system (i) In general Notwithstanding paragraph (1) and section 410.78(a)(3) of title 42, Code of Federal Regulations (or any successor regulation), subject to clause (v), on or after January 1, 2027, the term telecommunications system includes, in the case of the furnishing of a specified telehealth service (as defined in clause (ii)) a communications system that uses audio-only technology. (ii) Specified telehealth service In this subparagraph, the term specified telehealth service means a telehealth service described in clause (iii) that is furnished by a qualified provider (as defined in clause (iv)). (iii) Telehealth service described Subject to clause (vi), a telehealth service described in this clause is a telehealth service consisting of— (I) evaluation and management services; (II) behavioral health counseling and educational services; and (III) other services determined appropriate by the Secretary. (iv) Qualified provider defined For purposes of clause (ii), the term qualified provider means, with respect to a specified telehealth service that is furnished to an eligible telehealth individual— (I) a physician or practitioner who has an established patient relationship with such individual as defined by the State in which the individual is located; or (II) a critical access hospital (as defined in section 1861(mm)(1)), a rural health clinic (as defined in section 1861(aa)(2)), a Federally qualified health center (as defined in section 1861(aa)(4)), a hospital (as defined in section 1861(e)), a hospital-based or critical access hospital-based renal dialysis center (including satellites), a skilled nursing facility (as defined in section 1819(a)), a community mental health center (as defined in section 1861(ff)(3)(B)), or a rural emergency hospital (as defined in section 1861(kkk)(2)). (v) Authority For purposes of this subparagraph, the Secretary may determine whether it is clinically appropriate to furnish a specified telehealth service via a communications system that uses audio-only technology and whether an in-person initial visit (in addition to any requirement with respect to the furnishing of an item or service in person pursuant to clause (iv)(I)) is required prior to the furnishing of such service using such technology. (vi) Review (I) In general Not later than 5 years after the date of the enactment of this subparagraph, the Secretary shall conduct a review of the furnishing of specified telehealth services through audio-only technology pursuant to this paragraph. Such review shall include an analysis of the impact of the roll out of broadband technology and whether the use of audio-only technology is necessary to ensure access to such telehealth services. (II) Redetermination of specified telehealth services The Secretary may, based on the review conducted under subclause (I), provide for the addition or deletion of services (and HCPCS codes), as appropriate, to those specified in clause (ii) that may be furnished using audio-only technology and authorized for payment pursuant to this subparagraph. (vii) Clarification regarding payment The amount of payment for a specified telehealth service that is furnished using audio-only technology shall be equal to the amount that would have been paid for such service under this subsection had such service been furnished via any other telecommunications system authorized under this subsection..