Telehealth - JA DME
Telehealth
CMS has indicated that through January 30, 2026, beneficiaries can receive Medicare telehealth services anywhere in the United States and territories. Starting January 31, 2026, except for behavioral health services, beneficiaries will generally need to be in a medical facility in a rural area to receive Medicare telehealth services.
Telehealth services provided through telecommunication systems (e.g., computers and phones) allow health care providers to give care to patients remotely in place of an in-person visit.
The face-to-face encounter (in-person or telehealth) must be documented in the medical record (for example, history, physical examination, diagnostic tests, summary of findings, progress notes, treatment plans or other sources of information that may be appropriate). The supporting documentation must include subjective and objective beneficiary specific information used for diagnosing, treating, or managing a clinical condition for which the DMEPOS is ordered.
CMS has created a required Face-to-Face Encounter and Written Order Prior to Delivery List. Telehealth visits can serve as the required "face-to-face" encounter for a practitioner to evaluate a patient's condition and issue a valid order or prescription. This applies to most, but not all, items on the list.
The face-to-face regulation at 42 CFR 410.38(d)(2)(ii) allows for use of telehealth, provided that the requirements in 42 CFR 410.78 and 414.65 are met.
Suppliers are encouraged to confirm that the treating practitioner has provided and is billing a valid telehealth visit for the item(s) they have ordered. No specific type of verification is recommended or required. Confirmation of a valid visit protects suppliers in case of review and ensures beneficiaries receive the correct DMEPOS for their condition. A telehealth visit may be verified by a reviewing entity to make sure the visit qualifies as a face-to-face encounter when this is required before ordering DMEPOS.
Please contact your Part B contractor for more information.
