,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #gaed  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #aa1 #bjbj,mr4  
,br5dan ,f4 ,boyle ( ,p5nsylvania 7=    
himself1 ,mr4 ,bu*anan1 ,mr4 ,mi*ael ,f4
 ,doyle ( ,p5nsylvania1 ,mr4 ,pascrell1 
,mr4 ,soto1 ,mrs4 ,beatty1 ,ms4 ,%]rill1
 ,ms4 ,blunt ,ro*e/]1 & ,mr4 ,ru%7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to improve &     
ensure ongo+ ,m$ic>e b5efici>y access to
 outpati5t !rapy s]vices1 & = o!r       
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,outpati5t ,!rapy          
,mod]nization & ,/abilization ,act4  #b4
 ,mod]at+ annual ,m$ic>e reimbursem5t   
*anges  7a7 ,waiv+ c]ta9 rules ) respect
 to implem5tation ( adju/m5ts ( relative

 value units = evaluation & managem5t   
codes ,section #ahdh7;c77#b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#d7;c77#b77 is am5d$-- 7#a7 9    
subp>agraph 7,b77ii77,,ii71 by ins]t+   
aft] ,subject to clauses 7iv7 & 7v7 !   
foll[+3 & subp>agraph 7,p72  7#b7 9     
subp>agraph 7,f71 9 ! matt] prec$+      
clause 7i71 by /rik+ ,! & ins]t+        
,subject to subp>agraph 7,p71 !2 &  7#c7
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,p7 ,evaluation &        
managem5t codes ,! ,secret>y %all n     
apply subp>agraph 7,b77ii77,,ii7 7relat+
 to limitation on annual adju/m5ts 9    
relative values7 or subp>agraph 7,f7    
7relat+ to budget neutrality adju/m5ts7 
) respect to ! implem5tation ( adju/m5ts
 ( relative value units = ! evaluation &
 managem5t codes describ$ 9 ! f9al rule 
publi%$ by ! ,secret>y 9 ! ,f$]al       
,regi/] on ,novemb] #ae1 #bjai 7#hd ,f$4
 ,reg4 #fbefh1 #fbhdg-fbhfj71 = #bjba & 
ea* subsequ5t ye>4  4  7b7 ,increase 9  
update factor ,p>agraph 7#ai7 ( section 

#ahdh7;d7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciew-#d7;d77 is am5d$  
to read z foll[s3  7#ai7 ,update = #bjbj
 ?r\gh #bjbe ,! update to ! s+le        
conv]sion factor e/abli%$ 9 p>agraph    
7#a77;,c7 = #bjbj & ea* subsequ5t ye>   
?r\gh #bjbe %all be z foll[s3 7,a7 ,=   
#bjbj1 #j4j p]c5t4  7,b7 ,= #bjba1 #a4j 
p]c5t4  7,c7 ,= #bjbb & #bjbc1 #j4e     
p]c5t4  7,d7 ,= #bjbd & #bjbe1 #j4j     
p]c5t4  4  #c4 ,help+ outpati5t provid]s
 ?r\gh ! ,,covid-#ai p&emic  7a7        
,cl>ification ,! ?ird proviso ( ! ?ird  
p>agraph "u ! head+ ,(fice ( !          
,secret>y--,public ,heal? & ,social     
,s]vices ,em]g5cy ,fund 9 division ,b ( 
! ,coronavirus ,aid1 ,relief1 &         
,economic ,security ,act 7,public ,law  
#aaf-acf7 is am5d$ by ins]t+ 7includ+   
physicians1 physical !rapi/s1           
occupational !rapi/s1 spee* language    
pa?ology !rapi/s1 audiologi/s1          
psy*ologi/s1 social work]s1 & any o!r   
suppli] enroll$ ?r\gh "p ,b ( ! ,m$ic>e 
program "u title ,,xviii ( ! ,social    

,security ,act 7#db ,u4,s4,c4 #acie et  
seq477 aft] ,m$ic>e or ,m$icaid enroll$ 
suppli]s4  7b7 ,effective date ,!       
am5dm5t made by subsection 7a7 %all take
 effect z if includ$ 9 ! enactm5t ( !   
,coronavirus ,aid1 ,relief1 & ,economic 
,security ,act 7,public ,law #aaf-acf74 
#d4 ,mak+ appropriate !rapy s]vices     
accessible ?r\gh ! ,m$ic>e teleheal?    
program  7a7 ,m$ic>e b5efici>y access to
 !rapy s]vices dur+ national heal?      
em]g5cies  7#a7 ,p]mitt+ qualifi$       
!rapi/s to provide ,m$ic>e teleheal?    
!rapy s]vices ,not)/&+ any o!r provision
 ( law1 ) respect to ,m$ic>e teleheal?  
!rapy s]vices furni%$ on or aft] ,m>*   
#a1 #bjbj1 ) respect to an em]g5cy p]iod
 dur+ #bjbj1 a physical !rapi/1 an      
occupational !rapi/1 or a spee* language
 pa?ologi/ :o is enroll$ "u ! ,m$ic>e   
program "u title ,,xviii ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acie et  
seq471 or a facility t is p>ticipat+ 9  
su* program1 may furni% ,m$ic>e         
teleheal? !rapy s]vices to ,m$ic>e      

b5efici>ies dur+ su* em]g5cy p]iod "u ! 
same t]ms & conditions z ,m$ic>e        
teleheal? s]vices may be furni%$ by     
physicians or practition]s pursuant to !
 ,,covid-#ai int]im f9al rule4  7#b7    
,def9itions ,9 ?is subsection3 7,a7     
,,covid-#ai int]im f9al rule ,! t]m     
,,covid-#ai int]im f9al rule means !    
int]im f9al rule entitl$ ,m$ic>e &      
,m$icaid ,programs2 ,policy &           
,regulatory ,revisions 9 ,response to ! 
,,covid-#ai ,public ,heal? ,em]g5cy &   
publi%$ 9 ! ,f$]al ,regi/] by ! ,c5t]s =
 ,m$ic>e  ,m$icaid ,s]vices on ,april   
#f1 #bjbj 7#he ,f$4 ,reg4 #aibcj et     
seq474  7,b7 ,em]g5cy p]iod ,! t]m      
em]g5cy p]iod means ! ,,covid-#ai       
em]g5cy p]iod 7z describ$ 9 subsection  
7g77#a77;,b7 ( section #aace ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#acbj;b-#e77 or any o!r subsequ5t       
em]g5cy p]iod dur+ #bjbj ) respect to   
:i* an em]g5cy decl>ation describ$ 9    
subsection 7g77#a77;,a7 ( su* section is
 made4  7,c7 ,facility ,! t]m facility  

means an ag5cy1 cl9ic1 facility1        
hospital1 & entity describ$ 9 section   
#ahcc7;a77#h7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4#aciel7a77#h77 t furni%es
 ,m$ic>e teleheal? !rapy s]vices4  7,d7 
,m$ic>e teleheal? !rapy s]vices def9$ ,!
 t]m ,m$ic>e teleheal? !rapy s]vices    
means s]vices id5tifi$ by ,,hcpcs codes 
#ibejg-ibejh1 #ibeba-ibebd1 #ibebf1     
#ibfja-ibfjd1 #ibfjg-ibfaj1             
#ibfbf-ibfbg1 #ibfcj1 #ibfcc1 #ifaje1   
#ifabe1 #igaaj1 #igaab1 #igaaf1         
#igabi-igacj1 #igaej-igaeh1             
#igafa-igafh1 #igecj1 #igece1 #igedb1   
#iggej1 #iggee1 #iggfj1 & #iggfa-iggfc  
7& z subsequ5tly modifi$ by ! ,secret>y 
( ,heal? & ,human ,s]vices71 & :i* may  
be furni%$ to ,m$ic>e b5efici>ies ?r\gh 
teleheal? "u section #ahcd7m7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7m77 pursuant to ! ,,covid-#ai    
int]im f9al rule4  7,e7 ,occupational   
!rapi/ ,! t]m occupational !rapi/ means 
a qualifi$ occupational !rapi/ z t t]m  
is us$ 9 section #ahfa7;g7 ( ! ,social  

,security ,act 7#db ,u4,s4,c4           
#aciex7g774  7,f7 ,physical !rapi/ ,!   
t]m physical !rapi/ means a qualifi$    
physical !rapi/ z t t]m is us$ 9 section
 #ahfa7p7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciex7p774  7,g7 ,spee* 
language pa?ologi/ ,! t]m spee* language
 pa?ologi/ has ! mean+ giv5 ! t]m       
qualifi$ spee*-language pa?ologi/ 9     
section #ahfa7ll77#d77;,a7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#aciex7ll77#d77;,a774  7#c7             
,implem5tation ,not)/&+ any o!r         
provision ( law1 ! ,secret>y ( ,heal? & 
,human ,s]vices may implem5t ?is        
subsection by program in/ruction or     
o!rwise4  7b7 ,s]vices furni%$ beg9n+ 9 
#bjba  7#a7 ,9 g5]al ,section #ahcd7m7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciem7m77 is am5d$-- 7,a7 9 p>agraph  
7#a7-- 7i7 by /rik+ or a practition]    
7describ$ 9 section #ahdb7;b77#ah77;,c77
 & ins]t+ 1 a practition] 7z def9$ 9    
p>agraph 7#d77;,e771 or a facility 7z   
def9$ 9 p>agraph 7#d77;,g772 &  7ii7 by 

/rik+ individual physician or           
practition] & ins]t+ individual         
physician1 practition]1 or facility2    
7,b7 9 p>agraph 7#b7-- 7i7 9 subp>agraph
 7,a7-- 7,i7 by ins]t+ aft] locat$ at a 
di/ant site ! foll[+3 1 or a facility t 
is a di/ant site12 &  7,,ii7 by /rik+   
su* physician or practition] & ins]t+   
su* physician1 practition]1 or facility2
 &  7ii7 9 subp>agraph 7,c71 by /rik+ z 
det]m9$ by ! & ins]t+ z det]m9$ by a2   
7,c7 9 p>agraph 7#c77;,a7-- 7i7 9 !     
subp>agraph head+1 by /rik+ ,physician &
 practition] & ins]t+ ,physician1       
practition]1 & facility2 &  7ii7 by     
/rik+ a physician or practition] receiv+
 paym5t & all t foll[s ?r\gh ! p]iod &  
ins]t+ a physician1 practition]1 or     
facility receiv+ paym5t "u ?is          
subsection to ! same ext5t z !y apply to
 physicians1 practition]s1 or facilities
 "u su* sections42  7,d7 9 p>agraph     
7#d7-- 7i7 9 subp>agraph 7,a71 by ins]t+
 be=e ! p]iod ! foll[+3 1 or a facility 
t furni%es a teleheal? s]vice to an     

eligible teleheal? individual via a     
telecommuniciations sy/em2  7ii7 9      
subp>agraph 7,e71 by ins]t+ be=e ! p]iod
 at ! end ! foll[+3 1 & also includes1 =
 purposes ( ?is subsection1 a physical  
!rapi/1 an occupational !rapi/1 & a     
spee*-language pa?ologi/2  7iii7 9      
subp>agraph 7,f77i7-- 7,i7 by /rik+ &   
(fice psy*iatry & ins]t+ (fice          
psy*iatry2 &  7,,ii7 by ins]t+ be=e 1 & 
any additional ! foll[+3 1 !rapy s]vices
 7id5tifi$ z ( ,april #a1 #bjbj1 by     
,,hcpcs codes #ibejg-ibejh1             
#ibeba-ibebd1 #ibebf1 #ibfja-ibfjd1     
#ibfjg-ibfaj1 #ibfbf-ibfbg1 #ibfcj1     
#ibfcc1 #ifaje1 #ifabe1 #igaaj1 #igaab1 
#igaaf1 #igabi-igacj1 #igaej-igaeh1     
#igafa-igafh1 #igecj1 #igece1 #igedb1   
#iggej1 #iggee1 #iggfj1 & #iggfa-iggfc  
7& z subsequ5tly modifi$ by !           
,secret>y772 &  7iv7 by add+ at ! end ! 
foll[+ new subpragraph3  7,g7 ,facility 
,! t]m facility means an ag5cy1 cl9ic1  
facility1 hospital1 & entity describ$ 9 
section #ahcc7;a77#h7 ( ! ,social       

,security ,act 7#db                     
,u4,s4,c4#aciel7a77#h77 t furni%es !rapy
 s]vices describ$ 9 p>agraph            
7#d77;,f77i74  2 &  7,e7 by add+ at !   
end ! foll[+ new p>agraph3  7#i7        
,treatm5t ( teleheal? !rapy s]vices ,!  
geographic requirem5ts describ$ 9       
p>agraph 7#d77;,c77i7 %all n apply )    
respect to teleheal? s]vices t are !rapy
 s]vices describ$ 9 p>agraph            
7#d77;,f77i74  4  7#b7 ,effective date  
,! am5dm5ts made by p>agraph 7#a7 %all  
take effect on ! date ( ! enactm5t ( ?is
 ,act & apply to teleheal? s]vices      
furni%$ "u ! ,m$ic>e program on or aft] 
,janu>y #a1 #bjba4  #e4 ,r$uc+          
unnecess>y pap]work 9 ! deliv]y ( !rapy 
s]vices  7a7 ,9 g5]al ,section #ahce7;a7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acien7a77 is am5d$ by add+ at
 ! end ! foll[+ new s5t5ce3 ,!          
requirem5t = review ( a plan ( c>e      
describ$ 9 p>agraphs 7#b77;,c77ii7 &    
7#b77;,d77ii7 = outpati5t physical !rapy
 or outpati5t occupational !rapy s]vices

 or spee*-language pa?ology s]vices1    
respectively1 = an individual "u ! c>e (
 a physician %all be deem$ to be met if 
ei!r ( ! foll[+ is includ$ 9 !          
individual's m$ical record3 an ord] =   
su* outpati5t physical !rapy or         
outpati5t occupational !rapy s]vices or 
spee*-language pa?ology s]vices1 z !    
case may be1 sign$ by a physician "u :om
 ! individual is receiv+ c>e2 or a      
c]tification ( ! individual's plan ( c>e
 sign$ by a physician "u :om !          
individual is receiv+ c>e44  7b7 ,con=m+
 am5dm5t ,section #ahfa7p7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4 #aciex7p77
 is am5d$ by add+ at ! end ! foll[+ new 
s5t5ce3 ,! requirem5t = review ( a plan 
( c>e describ$ 9 p>agraph 7#b7 =        
physical !rapy s]vices furni%$ to an    
individual "u ! c>e ( a physician 7z s  
def9$7 %all be deem$ to be met if ei!r (
 ! foll[+ is includ$ 9 ! individual's   
m$ical record3 an ord] = su* physical   
!rapy s]vices sign$ by a physician "u   
:om ! individual is receiv+ c>e2 or a   

c]tification ( ! individual's plan ( c>e
 sign$ by a physician "u :om !          
individual is receiv+ c>e44