It’s nothing earth-shattering, but new guidance issued this month from the Department of Health & Human Services (HHS) on HIPAA security rules and audio-only telehealth visits may make the format more appealing .

How Are Practices Using Telehealth Now?

Telehealth continues to be a valuable and versatile care delivery option for many practices to broaden patient access while getting reimbursed for Medicare patients. It’s simply proven to be a win-win for both you and your patients:

  • Your patients like the convenience of being able to have a care appointment in the comfort of their home.
  • Healthcare practices prefer telehealth because they can offer patients a convenient option while also breaking down barriers to access, such as geography or transportation, to see more patients.

Many practices have found telehealth tools are the perfect way to offer more cost-effective hybrid care—a combination of telehealth and in-office visits based on the appointment type and other factors.

A recent study of a New England healthcare system found that 13.6 percent of established patient visits and 5.4 percent of new patient appointments are achieved via video telehealth appointments.

The same research found that telehealth usage varies widely based on your medical specialty. For example:

  • Mental health practices use video telehealth appointments more than any other specialty (40.3 percent of established patients and 35.9 percent of new patients).
  • Primary care providers conducted the most phone visits (22 percent of established patients and 8.3 percent of new patient appointments).
  • Specialty practices used telehealth the least (86.9 percent of new patients and 84.4 percent of established patients chose in-office visits).

And while telehealth helped a great many practices weather the worst of the pandemic, practitioners are continuing to find new ways to leverage remote visits.

While video telehealth appointments have given more patients greater access, the technology doesn’t work for everyone in every situation. Certain patient populations may have difficulty accessing video telehealth tools for a variety of reasons. These include financial resources, limited English proficiency, disability, internet access, cell coverage, and availability of broadband service (especially in rural areas).

Yet audio-only telehealth appointments, especially those that don’t require broadband availability, can help fill the care access needs of many of these patients.

What Is the New Guidance from HHS on HIPAA and Audio-Only Telehealth?

Because of this, the Department of Health & Human Services (HHS) issued new guidance on June 13 for HIPAA-covered healthcare practices and health plans. The guidance gives further directions on compliance of their use of audio-only telehealth services, and extends them beyond the current COVID-19 public health emergency.

In April 2020, the HHS Office of Civil Rights (OCR) essentially waived enforcement discretion of certain HIPAA rules to allow practices to roll out video telehealth services to their patients due to the health crisis. They agreed to not impose penalties for HIPAA noncompliance by practices for using remote technologies like telehealth to communicate with patients during the public health emergency.

But that notification by OCR for video telehealth appointments only remains in effect until HHS declares the public health emergency over. In contrast, the new guidance for audio-only telehealth visits doesn’t expire when the public health emergency declaration ends.

How Does the New HHS Guidance on HIPAA and Audio Telehealth Impact Me?

A few critical points in the new guidance on audio-only telehealth includes the following:

  • The HIPAA Security Rule does not apply to audio-only telehealth services using a standard telephone line. This is because the information is not transmitted electronically.
  • The security rule only applies when a healthcare practice or health plan uses electronic communication technology, such as Voice Over Internet Protocol, or mobile devices that use electronic media like internet, cellular, and Wi-Fi networks.
  • A healthcare practice or payer communicating with patients via phone call is not required to enter into a business associate agreement with a telecommunication service provider.

Though patient-provider phone communication is much less effective for coordinating care than text messaging, in these situations it makes sense to offer audio-only appointments to patients. You can still use patient communications tools to send appointment reminders, pre-visit instructions about the virtual care phone appointment, and to deliver post-care instructions and follow-up care reminders to help ensure patients keep their appointments.

That’s the great thing about technology. We can mold and adapt it to fit specific needs and situations to increase care access to patients and book more appointments.

Video telehealth and audio-only visits are both important options in your toolbox for various appointment types and to extend your reach to patients to help them overcome barriers to receiving care.


To learn more about how telehealth tools can expand your care access to more of your patients, download the guide, “10 Misconceptions about Telehealth and What Research Has to Say About It.”