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CMS Releases Guidance on the Allowance of Telehealth Encounters in eCQMs

On July 2, 2020 the Centers for Medicare and Medicaid Services (CMS) released guidance documents on the allowance of telehealth encounters for the Eligible Professional and Eligible Clinician electronic clinical quality measures (eCQMs) used in CMS quality reporting programs for the 2020 and 2021 performance periods. The guidance applies to eCQMs used in the:

  • Quality Payment Program: The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)

  • APM: Comprehensive Primary Care Plus (CPC+)

  • APM: Primary Care First (PCF)

  • Medicaid Promoting Interoperability Program for Eligible Professionals

The guidance documents list the telehealth-eligible eCQMs for their respective performance periods. Interestingly, there are 42 telehealth-eligible eCQMs for the 2020 performance period but only 39 for the 2021 performance period. The 2020 performance period guidance is available here. The 2021 performance period guidance is available here. CMS states that where an encounter can be identified with a telehealth-eligible code, it may be included in an eCQM regardless of whether the encounter was provided in person or via telehealth unless otherwise indicated by CMS in the guidance or in the eCWM definition statements. In both guidance documents, CMS notes that there may be instances where the quality action cannot be completed during the telehealth encounter, and that “it is the eligible professionals’ and eligible clinicians’ responsibility to make sure they can meet all other aspects of the quality action within the measure specification, including other quality actions that cannot be completed by telehealth.”

This post was co-authored by Michael Lisitano, legal intern at Robinson+Cole. 

Copyright © 2020 Robinson & Cole LLP. All rights reserved.National Law Review, Volume X, Number 189

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About this Author

Conor Duffy Cybersecurity Attorney
Associate

Conor Duffy is a member of the firm's Health Law Group and its Data Privacy + Cybersecurity Team. He advises hospitals, physician groups, community providers, and other health care entities on general corporate matters and health law issues. He also counsels clients on what measures are needed to safeguard data and patient information.

Regulatory

Conor provides legal counsel to health care clients on various regulatory matters, such as Medicare and Medicaid program compliance, federal fraud and abuse laws, and the Emergency Medical Treatment & Labor Act...

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