Question Telehealth and coronavirus

trarut

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Has anyone else confirmed that Medicare is allowing telehealth services during the coronavirus outbreak? I'm buried in various articles and having trouble interpreting all the different pieces of information. Of course, CMS can't state it plainly but I feel like that's what I'm reading - providers who don't normally qualify to bill telehealth services can bill them during the outbreak if the area where they are located has a declared state of emergency as a result of the virus.

The practice I work for is not in an area that qualifies for rural health benefits so we aren't normally eligible to bill telehealth services for Medicare patients. We don't currently have any cases in our county but the governor has declared a state of emergency (or so I've been told) so I've been instructed to determine if these are now billable services.

Any input is appreciated!
Tracy
 

cfederico

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I found this on CMS.GOV this morning.

I am struggling to understand if my providers can bill telephone calls. Patients are calling wanting to talk to the provider to see if they need to be tested. The provider is reviewing their symptoms and taking a history then deciding if he/she should send patient to a testing facility. We are not bringing patients in to see the provider.
 

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pdinapoli

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I work in a primary care physician office looking to limit patient interaction and primarily use phone or video capabilities. These services are entirely new and never billed prior to the national emergency. I have begun billing 99441-99443, 98966-98962 and G2012. I am trying to gain clarity on Medicare emergency rules giving patients access to telehealth. I am reading it as thought the physician can bill for telehealth if they use Facetime and has been treating patient for 3 years same condition? Any additional information or clarification on this topic would be greatly appreciated.
 

arkassabaum

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I'd like to know more about non physician phone services during this time. Does the AAPC plan on sending something out to assist with education and support during this time?
 

b.cobuzzi

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Have you guys read the new CMS announcement based on the virus that Telehealth rules have been loosened? There is a blog in the Knowledge Center and there will be another one coming tomorrow or Thursday with more details. There are links to the CMS pages in the blog for you (large blue words)

But to summarize,
  • Waive geographic restrictions, meaning patients can receive telehealth services in non-rural areas;
  • Waive originating site restrictions, meaning patients can receive telehealth services from their home;
  • Allow use of telephones that have audio and video-capabilities; stored information
  • Encounter has to be patient initiated
  • Allow reimbursement for any telehealth services “covered code”, including Office Visits (99201-99215), even if unrelated to COVID-19 diagnosis, screening, or treatment; and
  • Will not enforce the established patient relationship requirement, as determined by CPT Guidelines that a patient see a provider within the last three years.
 
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Clinton, SC
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Have you guys read the new CMS announcement based on the virus that Telehealth rules have been loosened? There is a blog in the Knowledge Center and there will be another one coming tomorrow or Thursday with more details. There are links to the CMS pages in the blog for you (large blue words)

But to summarize,
  • Waive geographic restrictions, meaning patients can receive telehealth services in non-rural areas;
  • Waive originating site restrictions, meaning patients can receive telehealth services from their home;
  • Allow use of telephones that have audio and video-capabilities; stored information
  • Encounter has to be patient initiated
  • Allow reimbursement for any telehealth services “covered code”, including Office Visits (99201-99215), even if unrelated to COVID-19 diagnosis, screening, or treatment; and
  • Will not enforce the established patient relationship requirement, as determined by CPT Guidelines that a patient see a provider within the last three years.

With this information, will the POS be 02? and not POS 11, at this time if we are treating over the phone?
 

KTOWNSEL

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I cant find any reimbursement info from medicare...the fee schedule says zero is their allowable on telemed codes
 

trarut

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Have you guys read the new CMS announcement based on the virus that Telehealth rules have been loosened? There is a blog in the Knowledge Center and there will be another one coming tomorrow or Thursday with more details. There are links to the CMS pages in the blog for you (large blue words)

But to summarize,
  • Waive geographic restrictions, meaning patients can receive telehealth services in non-rural areas;
  • Waive originating site restrictions, meaning patients can receive telehealth services from their home;
  • Allow use of telephones that have audio and video-capabilities; stored information
  • Encounter has to be patient initiated
  • Allow reimbursement for any telehealth services “covered code”, including Office Visits (99201-99215), even if unrelated to COVID-19 diagnosis, screening, or treatment; and
  • Will not enforce the established patient relationship requirement, as determined by CPT Guidelines that a patient see a provider within the last three years.
Thanks for the summary, Barbara. That's very helpful!
 

trarut

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So to add a question to my own question - anyone know if telehealth services are billable incident-to? I'm leaning toward no but looking for other opinions on the topic.
 

eurodurk

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Is audio only telehealth billable? We have multiple patients that don't have video capabilities.
From what I've seen, audio only is billable, but only when it is for an established patient. For any new patients, it would have to have both the audio and the visual components.

I found the fact sheet posted by CMS to be very helpful in determining what codes our practice could bill. The relevant information for telephone visits is under "virtual check in". I did notice that, per this fact sheet and the table at the bottom of the article, that the CPT codes which describe a telephone visit (99441-99443) are not being accepted by Mediare. Rather, they are accepting two HCPCS codes (G2012 and G2010).

Link to the fact sheet:
 

b.cobuzzi

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Audio only can only be billed with G2012 - Virtual check in. Use POS 02

AAPC is offering a webinar on Telehealth under COVID-19 exceptions for $49. I just got an email.
 

b.cobuzzi

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Depending on the Medicare carrier and non-medicare carrier you call, you get different answers. Some say that POS 02 are used for G2012 and others want 11. G2012 is not Telehealth since it does not involve video. So the best I can tell you is to check with your carrier if you are billing the phone only codes. It definitely is 02 if you are billing audiovideo telehealth services and codes such as 99201-99215. That is how the payer knows the visit is not in the office.
 

csperoni

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Selden
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Does anyone know if CMS is doing a telehealth teleconference soon and how the register?
I don't think CMS itself typically does webinars about this type of stuff. The various MACs may be offering webinars. NGS Medicare had one last week (03/25/20) that I attended, but 1/2 the information has changed since then. Honestly, with the information changing daily, the MACs themselves are probably scrambling to keep up to date.
Novitas is offering a telehealth webinar on 04/09/20 https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00008044
 
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