What to Know About Telehealth During the Coronavirus Crisis
The US government and public-health officials are urging consumers to utilize telemedicine for remote treatment, fill prescriptions and get medical attention during the new coronavirus pandemic. The goal is to keep people with symptoms at home and to practice social distancing if their condition doesn’t warrant more intensive hospital care. The new emphasis is designed to free up doctors and other front-line providers by encouraging patients with nonemergent related symptoms to COVID-19 and unrelated ailments such as diabetes to get care online.
How much does telehealth cost?
That depends on your insurance plan. Insurance plans may cover telehealth if it is provided directly by a doctor or hospital, or through a telehealth service. Some consumers may have a copay or other out-of-pocket charge. Medicare will now cover telehealth services and Medicare Advantage plans may waive or reduce cost sharing.
As a consumer, you should do your homework and see if your insurance provider covers telehealth. Out-of-pocket costs can range from $50-$80. Check with your local providers.
What does all this mean for the HIM industry?
There may be a surge of online, telehealth, telephone patient visits by patients who do not want to come in for a face to face office visit. If your coders are responsible for coding professional fee claims for these providers, they should review the guidelines for CPT codes at each section and subsection for Non-Face-to-Face Physician and Nonphysician services. Below is a list of sections/subsections to review:
- Non-Face-to-Face On-Line Digital Evaluation and Management Services (99421-99423)
- Interprofessional Telephone/Internet/Electronic Health Record Consultations (99446-99452)
- Digitally Stored Data and Remote Physiologic Monitoring Services (99091-99474)
- Remote Physiologic Monitoring Treatment Management Services (99457-99458)
- Non-Face-to-Face Nonphysician Telephone Services (98966-98968)
- Non-Face-to-Face Online Digital Evaluation and Management Service by Qualified Nonphysician Health Care Professional (98970-98972)
Coders should also review the guidelines below for COVID-19 diagnosis and CPT laboratory test coding.
CPT Laboratory Code for COVID-19: https://www.ama-assn.org/practice-management/cpt/cpt-releases-new-coronavirus-covid-19-code-description-testing
Coverage and Payment Related to COVID-19 Medicare: https://www.cms.gov/files/document/03052020-medicare-covid-19-fact-sheet.pdf