Medicare Telehone Visits

jhendrix08

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Hi everyone...

As some of you may know, CMS announced they will be increasing the reimbursement amount for telephone calls (audio only) billed during the pandemic. The increase was to be retroactive to March 1st. It applies to CPT codes 99441 - 99443. The increase is going from $14-$41 to $46 -$110.

I have received some EOB's from Medicare (Noridian) and the telephone calls we have billed recently (within the past two weeks) are still showing the old reimbursement amount.

Thoughts?? Thanks so much, in advance.
 
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My state's fee schedule (FL) is not updated to reflect the new fees yet and I can't find anything referencing it beyond the press release and interim rule. One of my concerns is if they are going to automatically re-process the previously paid claims at the higher rate, and how they will handle it if what we charged at the time was not as high as the new reimbursement. I am worried we may have to refile corrected claims with a higher charge amount to get the max reimbursement.
 

jhendrix08

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My state's fee schedule (FL) is not updated to reflect the new fees yet and I can't find anything referencing it beyond the press release and interim rule. One of my concerns is if they are going to automatically re-process the previously paid claims at the higher rate, and how they will handle it if what we charged at the time was not as high as the new reimbursement. I am worried we may have to refile corrected claims with a higher charge amount to get the max reimbursement.
Completely agree with everything you said; that's also a concern of mine. I appreciate your feedback!
 

t.rodgers@nwbchcc.org

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Hello,
How are you billing the telephone visits to MCR? I am a FQHC facility and I have a unique way to bill. I was billing out using MOD CR and claims got processed for payment. However, I am now seeing that the rules have changed but I am still unclear. I have tried a few samples to see if they pay and they are not. I am just curious on how you are billing now?

4608
 

sbosley

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Not sure if you have seen any, but Novitas (Tx MAC) is reprocessing claims beginning March 1st to new reimbursement amount. Yours should do the same. They are also now reimbursing current claims correctly. I'm sure each MAC has it's own timelines. Also make sure you are using the correct POS 11, rather than 02. I made that mistake in the beginning.
 

jhendrix08

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Not sure if you have seen any, but Novitas (Tx MAC) is reprocessing claims beginning March 1st to new reimbursement amount. Yours should do the same. They are also now reimbursing current claims correctly. I'm sure each MAC has it's own timelines. Also make sure you are using the correct POS 11, rather than 02. I made that mistake in the beginning.
Thank you for this. Our MAC is Noridian; haven't seen any claim reprocessed with the new reimbursement amount yet but this makes me hopeful. :) Yes, I have been billing with POS 11. Thanks again for this update!!
 

jhendrix08

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I called Palmetto just a few days ago regarding claims and higher reimbursement and was told Medicare is in process and the provider office does not need to resubmit. I had already resubmitted a few claims and they got denied as duplicates, so I called and was told to do nothing, but wait. Hope this helps.
This is very helpful....thanks so much!!
 

Amrita

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I have a question. There are patients who suffer from illness, but due to this covid situation do not make the visit to providers. Phone calls are supposed to be initiated by the patients. But as of now due to Covid..Can the physician initiate a phone call ( 99441*99443) to inquire about those established patients who they know have some condition and ask how they were doing?
 
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