529 
(A) in the heading, by striking ‘‘PHYSI-
CIAN AND PRACTITIONER’’ and inserting ‘‘PHY-
SICIAN, PRACTITIONER, AND APPLICABLE PRO-
FESSIONAL’’; and 
(B) by striking ‘‘physicians or practi-
tioners’’ and inserting ‘‘physicians, practi-
tioners, or applicable professionals’’; and 
(4) in paragraph (4), by adding at the end the 
following new subparagraph: 
‘‘(G) APPLICABLE
PROFESSIONAL.—The 
term ‘applicable professional’ means, with re-
spect to services furnished on or after the date 
that is 6 months after the date of the enact-
ment of this subparagraph, a certified diabetes 
educator or licensed— 
‘‘(i) respiratory therapist; 
‘‘(ii) audiologist; 
‘‘(iii) occupational therapist; 
‘‘(iv) physical therapist; or 
‘‘(v) speech language pathologist.’’. 
(c) HOME-BASED MONITORING SERVICES FOR CON-
GESTIVE HEART FAILURE AND CHRONIC OBSTRUCTIVE 
PULMONARY DISEASE.— 
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530 
(1) COVERAGE
OF
REMOTE
PATIENT
MONI-
TORING SERVICES FOR CERTAIN CHRONIC HEALTH 
CONDITIONS.— 
(A) IN GENERAL.—Section 1861(s)(2) of 
the Social Security Act (42 U.S.C. 1395x(s)(2)) 
is amended— 
(i) in subparagraph (GG), by striking 
‘‘and’’ at the end; 
(ii) in subparagraph (HH), by insert-
ing ‘‘and’’ at the end; and 
(iii) by inserting after subparagraph 
(HH) the following new subparagraph: 
‘‘(II) applicable remote patient monitoring 
services (as defined in paragraph (1)(A) of sub-
section (iii));’’. 
(2) SERVICES
DESCRIBED.—Section 1861 of 
the Social Security Act (42 U.S.C. 1395x) is amend-
ed by adding at the end the following new sub-
section: 
‘‘(kkk) REMOTE PATIENT MONITORING SERVICES 
FOR CHRONIC HEALTH CONDITIONS.— 
‘‘(1)(A) The term ‘applicable remote patient 
monitoring services’ means remote patient moni-
toring services (as defined in subparagraph (B)) fur-
nished to provide for the monitoring, evaluation, and 
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management of an individual with a covered chronic 
condition (as defined in paragraph (2)), insofar as 
such services are for the management of such chron-
ic condition. 
‘‘(B) The term ‘remote patient monitoring serv-
ices’ means services furnished through remote pa-
tient monitoring technology (as defined in subpara-
graph (C)). 
‘‘(C) The term ‘remote patient monitoring tech-
nology’ means a coordinated system that uses one or 
more home-based or mobile monitoring devices that 
automatically transmit vital sign data or information 
on activities of daily living and may include re-
sponses to assessment questions collected on the de-
vices wirelessly or through a telecommunications 
connection to a server that complies with the Fed-
eral regulations (concerning the privacy of individ-
ually identifiable health information) promulgated 
under section 264(c) of the Health Insurance Port-
ability and Accountability Act of 1996, as part of an 
established plan of care for that patient that in-
cludes the review and interpretation of that data by 
a health care professional. 
‘‘(2) For purposes of paragraph (1), the term 
‘covered chronic health condition’ means applicable 
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532 
conditions (as defined in and applied under section 
1886(q)(5)) when under chronic care management 
(identified as of July 1, 2015, by HCPCS code 
99490 (and as subsequently modified by the Sec-
retary)). 
‘‘(3)(A) Payment may be made under this part 
for applicable remote patient monitoring services 
provided to an individual during a period of up to 
90 days and such additional period as provided for 
under subparagraph (B). 
‘‘(B) The 90-day period described in subpara-
graph (A), with respect to an individual, may be re-
newed by the physician who provides chronic care 
management to such individual if the individual con-
tinues to qualify for such management.’’. 
(3) PAYMENT
UNDER
THE
PHYSICIAN
FEE 
SCHEDULE.—Section 1848 of the Social Security 
Act (42 U.S.C. 1395w–4) is amended— 
(A) in subsection (c)— 
(i) in paragraph (2)(B)— 
(I) in clause (ii)(II), by striking 
‘‘and (v)’’ and inserting ‘‘(v), and 
(vii)’’; and 
(II) by adding at the end the fol-
lowing new clause: 
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533 
‘‘(vii) BUDGETARY
TREATMENT
OF 
CERTAIN
SERVICES.—The additional ex-
penditures attributable to services de-
scribed in section 1861(s)(2)(II) shall not 
be taken into account in applying clause 
(ii)(II).’’; and 
(ii) by adding at the end the following 
new paragraph: 
‘‘(7) TREATMENT OF APPLICABLE REMOTE PA-
TIENT MONITORING SERVICES.— 
‘‘(A) In determining relative value units 
for applicable remote patient monitoring serv-
ices (as defined in section 1861(iii)(1)(A)), the 
Secretary, in consultation with appropriate phy-
sician groups, practitioner groups, and supplier 
groups, shall take into consideration— 
‘‘(i) physician or practitioner re-
sources, including physician or practitioner 
time and the level of intensity of services 
provided, based on— 
‘‘(I) the frequency of evaluation 
necessary to manage the individual 
being furnished the services; 
‘‘(II) the complexity of the eval-
uation, including the information that 
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must be obtained, reviewed, and ana-
lyzed; and 
‘‘(III) the number of possible di-
agnoses and the number of manage-
ment options that must be considered; 
‘‘(ii) practice expense costs associated 
with such services, including the direct 
costs associated with installation and infor-
mation transmission, costs of remote pa-
tient 
monitoring 
technology 
(including 
equipment and software), device delivery 
costs, and resource costs necessary for pa-
tient monitoring and followup (but not in-
cluding costs of any related item or non- 
physician service otherwise reimbursed 
under this title); and 
‘‘(iii) malpractice expense resources. 
‘‘(B) Using the relative value units deter-
mined in subparagraph (A), the Secretary shall 
provide for separate payment for such services 
and shall not adjust the relative value units as-
signed to other services that might otherwise 
have been determined to include such separately 
paid remote patient monitoring services.’’; and 
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535 
(B) in subsection (j)(3), by inserting 
‘‘(2)(II),’’ after ‘‘health risk assessment),’’. 
SEC. 432. EXPANDING THE USE OF TELEHEALTH THROUGH 
THE WAIVER OF CERTAIN REQUIREMENTS. 
(a) IN GENERAL.—Section 1834(m) of the Social Se-
curity Act (42 U.S.C. 1395m(m)) is amended— 
(1) in paragraph (4)(C)(i), by striking ‘‘and 
(7)’’ and inserting ‘‘(7), and (8)’’; and 
(2) by adding at the end the following: 
‘‘(8) AUTHORITY
TO
WAIVE
REQUIREMENTS 
AND LIMITATIONS IF CERTAIN CONDITIONS MET.— 
‘‘(A) IN
GENERAL.—Notwithstanding the 
preceding provisions of this subsection, in the 
case of telehealth services furnished on or after 
January 1, 2021, the Secretary may waive any 
restriction applicable to payment for telehealth 
services under this subsection that is described 
in subparagraph (B), but only if the Secretary 
determines that such waiver would not deny or 
limit the coverage or provision of benefits under 
this title, and— 
‘‘(i) the Secretary determines that the 
waiver is expected to reduce spending 
under this title without reducing the qual-
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536 
ity of care or improve the quality of pa-
tient care without increasing spending; or 
‘‘(ii) the waiver would apply to tele-
health services furnished in originating 
sites located in a high-need health profes-
sional shortage area (as designated pursu-
ant to section 332(a)(1)(A) of the Public 
Health 
Service 
Act 
(42 
U.S.C. 
254e(a)(1)(A))). 
‘‘(B) 
RESTRICTIONS
DESCRIBED.—For 
purposes of this paragraph, restrictions applica-
ble to payment for telehealth services under 
paragraph (1) are— 
‘‘(i) requirements relating to qualifica-
tions for an originating site under para-
graph (4)(C)(ii); 
‘‘(ii) any geographic limitations under 
paragraph (4)(C)(i) (other than applicable 
State law requirements, including State li-
censure requirements); 
‘‘(iii) any limitation on the type of 
technology used to furnish telehealth serv-
ices; 
‘‘(iv) any limitation on the type of 
provider of services or supplier who may 
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furnish telehealth services (other than the 
requirement that the provider of services 
or supplier is enrolled under this title); 
‘‘(v) any limitation on specific services 
designated as telehealth services pursuant 
to this subsection (provided the Secretary 
determines that such services are clinically 
appropriate to furnish remotely); or 
‘‘(vi) any other limitation relating to 
the furnishing of telehealth services under 
this title identified by the Secretary. 
‘‘(C) PUBLIC
COMMENT.—The Secretary 
shall establish a process by which stakeholders 
may (on at least an annual basis) provide public 
comment for waivers under this paragraph. 
‘‘(D) PERIODIC
REVIEW
OF
WAIVERS.— 
The Secretary shall periodically, but not more 
often than every 3 years, reassess each waiver 
under this paragraph to determine whether the 
waiver continues to meet the conditions applica-
ble under subparagraph (A).’’. 
(b) POSTING OF INFORMATION.—Not later than 2 
years after the date on which a waiver under section 
1834(m)(8) of the Social Security Act, as added by sub-
section (a), first becomes effective, and at least biennially 
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thereafter, the Secretary of Health and Human Services 
shall post on the internet website of the Centers for Medi-
care & Medicaid Services— 
(1) the number of Medicare beneficiaries receiv-
ing telehealth services by reason of each waiver 
under such section; 
(2) the impact of such waivers on expenditures 
and utilization under title XVIII of the Social Secu-
rity Act (42 U.S.C. 1395 et seq.); and 
(3) other outcomes, as determined appropriate 
by the Secretary. 
SEC. 433. EXPANDING THE USE OF TELEHEALTH FOR MEN-
TAL HEALTH SERVICES. 
(a) IN GENERAL.—Section 1834(m) of the Social Se-
curity Act (42 U.S.C. 1395m(m)), as amended by the pre-
ceding sections, is amended— 
(1) in paragraph (4)(C)(i), by striking ‘‘and 
(8)’’ and inserting ‘‘(8), and (9)’’; and 
(2) by adding at the end the following: 
‘‘(9) TREATMENT OF MENTAL HEALTH SERV-
ICES FURNISHED THROUGH TELEHEALTH.—The ge-
ographic 
requirements 
described 
in 
paragraph 
(4)(C)(i) (other than applicable State law require-
ments, including State licensure requirements) shall 
not apply with respect to telehealth services that are 
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mental health services (as determined by the Sec-
retary) furnished on or after January 1, 2021, to an 
eligible telehealth individual at an originating site 
described in paragraph (4)(C)(ii) (other than an 
originating site described in subclause (IX) of such 
paragraph).’’. 
(b) INCLUSION OF THE HOME AS AN ORIGINATING 
SITE.—Section 1834(m)(4)(C)(ii)(X) of such Act (42 
U.S.C. 1395m(m)(4)(C)(ii)(X)) is amended by striking 
‘‘paragraph (7)’’ and inserting ‘‘paragraphs (7) and (9)’’. 
(c) ADDITIONAL SERVICES.—As part of the imple-
mentation of the amendments made by this section, the 
Secretary of Health and Human Services shall consider 
whether additional services should be added to the services 
specified in paragraph (4)(F)(i) of section 1834(m) of 
such Act (42 U.S.C. 1395m) for authorized payment 
under paragraph (1) of such section. 
SEC. 434. USE OF TELEHEALTH IN EMERGENCY MEDICAL 
CARE. 
(a) IN GENERAL.—Section 1834(m) of the Social Se-
curity Act (42 U.S.C. 1395m(m)), as amended by the pre-
ceding sections, is amended— 
(1) in paragraph (4)(C)(i), by striking ‘‘and 
(9)’’ and inserting ‘‘(9), and (10)’’; and 
(2) by adding at the end the following: 
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