Wiki Telehealth Services

[marilou@mmsiva.com]

We are needing some clarification, I have multiple providers that are wanting to provide the telehealth services but CMS guidelines are vague and confusing when it comes to inpatient and skilled nursing. I have reviewed all the guidelines and everything on line and still no clarification on the following codes.

• Subsequent hospital care services, with the limitation of one telehealth visit
every 3 days (CPT codes 99231, 99232, and 99233) – Here is the question if the patient is in patient how do they determine the every 3 days. If a patient is in the hospital they are "normally" being seen by a physician daily. Is there a way to make this more clear for my providers?

• Subsequent nursing facility care services, with the limitation of one telehealth
visit every 30 days (CPT codes 99307, 99308, 99309, and 99310) – The question is if the patient is in Nursing Home and has multiple episodes what determines the 1 telehealth visit every 30 days. Is there a clear way to determine this for my providers?

 

[thomas7331]

I responded to your question in the practice management section, but just to summarize again, in my experience telehealth is meant just for a consultation service and not to replace daily care. If a patient requires E&M by a particular specialty more frequently than what is allowed by telehealth, in-persons visits are more appropriate and the facility will transfer that patient to another location where that is available.