Reporting Telehealth Services During the COVID-19 Emergency

On March 6, CMS lifted some restrictions on the reporting of telehealth visit codes during the COVID-19 pandemic:

  • 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.  This is great for providers whose patients are reluctant to visit the office.
  • Medicare patients can receive telehealth services in all areas of the country and in all settings.  This would include in their home, SNF, assisted living facilities, home health, hospice etc.   Documentation requirements must still be met.
  • CMS will not require that patients have an established relationship with the physician providing the telehealth service. The physician will be able to perform a telehealth visit with a new patient.
  • 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
  • In addition, CPT telehealth modifier 95 should be applied to the claim that describe services furnished via telehealth.  This will insure the provider is paid a higher rate than normal telehealth visits during the COVID-19 pandemic.
  • 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. See this at the CMS website: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
  • Any technology with audio and video can be used for telehealth services that would include non-public facing communication.  This would allow video chats, including Apple FaceTime, Facebook Messenger video chat, SKYPE or Google Hangouts video to provide telehealth without risk of penalty for noncompliance with  HIPAA Rules.

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