Important Telehealth Coding Advice during COVID-19

The Centers for Medicare & Medicaid Services (CMS) lifted Medicare restrictions on the use of telehealth services during the COVID-19 emergency.

TELEHEALTH FACTS:

  • Effective March 1, Medicare will pay physicians for telehealth services at the same rate as in-person visits for all diagnoses, not just services related to COVID-19
  • Medicare patients can receive telehealth services in all areas of the country and in all settings, no matter where they reside i.e their home, SNF, assisted living facilities, home health, hospice etc. Physicians and practitioners who bill for Medicare telehealth services are directed to report the place of service (POS) code that would have been reported had the service been furnished in person
  • CMS will not require that patients have an established relationship with the physician providing the telehealth service
  • CPT telehealth modifier 95 should be applied to claim lines that describe services furnished via telehealth
  • Telehealth can be provided to patients by physicians and certain non-physician practitioners. CMS maintains a list of services that may be furnished via Medicare telehealth. The list is available here: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
  • Any technology with audio and video can be used for telehealth services. The Office of Civil Rights allows video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype to provide telehealth without risk of penalty for noncompliance with the HIPAA Rules. *Section 1135(B)(8) of the Social Security Act allows the Secretary to authorize use of phones by practitioners to provide Medicare telehealth services if their phones have audio and video capabilities for the furnishing of Medicare telehealth services during COVID-19 PHE (Public Health Emergency)

Ref: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes

Discharges on or after April 1, 2020 https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf

Discharges prior to April 1, 2020 https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

Posted in