As most practices are aware, CMS’ telehealth waivers expired on October 1 following the government shutdown. That doesn’t mean patients have stopped requesting telehealth appointments, however. Many practices report that patients still want to meet with their providers without leaving home by engaging in telemedicine visits. This puts practices in a challenging situation, because you certainly don’t want to lose revenue for these visits, and you don’t want to upset patients.

In some cases, using advance beneficiary notices (ABNs) may be just what you need. Discover how using an ABN can help you collect for your telehealth visits.

Send ABNs for Most Telehealth Visits

Keep in mind that telehealth visits are still payable by Medicare for behavioral health and mental health services. But that still leaves out scores of other reasons patients may want to see you for telehealth. This includes sick visits like pinkeye, COVID-19 and stomach bugs, as well as visits for patients who aren’t sick, such as medication follow-ups.

When those Medicare patients request a telehealth visit, explain to them that Medicare’s telehealth waivers expired on October 1, and that the answer to whether those waivers will be reinstated depends on the government’s actions going forward. Let them know that while this is out of your hands, you are still committed to providing care for them, but that the telehealth visit may not be covered. Due to that, you’ll be asking them to sign an ABN explaining that Medicare may not cover the visit, along with the dollar amount they may be responsible for paying if it’s denied.

Let them know that they can choose not to get the telehealth service if they don’t want to pay for it, in which case they may need to come into the office if they want to get the service in person and have it covered by Medicare.

In black and white: CMS and most Part B payers are advising practices to keep ABNs on hand throughout this period. “In the absence of Congressional action, practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to evaluate providing beneficiaries with an Advance Beneficiary Notice of Noncoverage,” says Part B MAC Palmetto GBA. “Practitioners should monitor Congressional action and may choose to hold claims associated with telehealth services that are not payable by Medicare in the absence of Congressional action. Additionally, Medicare would not be able to pay some kinds of practitioners for telehealth services.”