CMS Proposes Extending Virtual Direct Supervision through End of 2024

News Update

In a significant development for the healthcare industry, the Centers for Medicare & Medicaid Services (CMS) unveiled the Calendar Year 2024 Physician Fee Schedule Proposed Rule on July 13, 2023. This proposed rule introduces a pivotal change by extending the use of remote supervision, specifically allowing "direct supervision" through audio and visual interactive telecommunications through December 31, 2024.

The concept of "direct supervision" is crucial in the realm of Medicare Part B services, typically mandating the physical presence of a supervising professional during certain medical procedures. However, the COVID-19 pandemic led to adaptations in healthcare practices, and one such adaptation was the allowance of remote "direct supervision." This involved utilizing real-time audio or video technology to virtually oversee procedures.

The original policy permitting remote direct supervision was set to expire at the close of 2023, raising concerns within the healthcare community about a potential reversion to pre-pandemic norms. Nevertheless, CMS, in its proposed rule, emphasized the absence of compelling evidence indicating any compromise in patient safety through virtual direct supervision.

The move to extend remote direct supervision is significant for several reasons. Firstly, it acknowledges the transformative impact of telehealth services on healthcare accessibility, particularly in rural and underserved areas. The adoption of telehealth during the pandemic democratized healthcare by bridging geographical gaps and improving patient access.

Furthermore, the proposed extension aligns with other telehealth-related policies enacted during the Public Health Emergency. The expiration of this policy could potentially erect barriers to healthcare access, disrupting the continuity of care for patients and causing logistical challenges for healthcare providers.

The proposed extension of virtual direct supervision until December 31, 2024, is, in essence, a reflection of the healthcare landscape's evolution. As healthcare professionals have adapted and embraced new practices during the pandemic, an abrupt reversion to pre-PHE policies could be cumbersome and appears unlikely.

What's particularly noteworthy is CMS's intention to further evaluate the possibility of permanently extending the definition of direct supervision beyond December 31, 2024. This suggests that the healthcare industry may be on the cusp of a more enduring transformation in the way supervision is defined and implemented.

While the implications of this proposed rule are far-reaching, it's essential to recognize the dynamic nature of healthcare policy and maintain flexibility to operate regardless of outcomes.