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COVID-19 Telehealth Resource

Telehealth

On March 17, 2020, the Centers for Medicare and Medicaid Services announced expanded Medicare telehealth coverage. Beginning on March 6, 2020, Medicare will temporarily pay clinicians to provide telehealth services for beneficiaries across the entire country. The information below collects all of the information from the federal government surrounding this declaration for easy perusal by the members of AAOE.

CMS Memo on Telehealth Services

Access here

 CMS Update on Telehealth 4/02/2020 Access Here
CMS Frequently Asked QuestionsAccess here
OIG Waiver Announcement on Benficiary Cost SharingAccess here

CMS Press Release on Telehealth

Access here

CMS Provider Fact Sheet on Telehealth

Access here

OCR Statement on HIPAA Enforcement Discretion for Telehealth Services           

Access here

MLN Matters Article on Telehealth Billing
Access here
CMS Telemedicine ToolkitAccess here

 

 

 

 

 

 

 

 

 

 

 

 

 

Billing for Telehealth Services

Medicare has three types of "virtual visits", Medicare Telehealth Visits, Virtual Check-Ins, and eVisits. The 1135 waivers released in March 2020 only apply to Medicare Telehealth Visits.

  • For Medicare Telehealth Visits:
    • Defined as a visit with a provider that uses telecommunication systems between a provider and patient.
    • When billing for new and established patients (99201-99215), append the 02 place of service code to indicate the place of service as telehealth and, if the service was provided via asynchronous telecommunication system (i.e. store and forward technology) the GQ modifier should also be appended.
  • For Virtual Check Ins
    • Defined as a brief (5-10 minutes) established patient check-in with a practitioner via telephone or other telecommunications device to decide whether a office visit is necessary or a remote evaluation of recorded video and/or images submitted by a new or established patient.
    • Bill G2012 (brief communication) or G2010 (remote evaluation)
  • For eVisits
    • Defined as a communication between an established patient and their provider through an online patient portal.
    • Bill 99421 (online digital E/M service; 5-10 minutes), 99422 (online digital E/M service; 11-20 minutes), 99423 (online digital E/M service; 21 or more minutes), G2061 (Qualified non-physician health care professional online assessment; 5-10 minutes), G2062 (Qualified non-physician health care professional online assessment; 11-20 minutes), G2063 (Qualified non-physician health care professional online assessment; 21 or more minutes) 

FAQ's About Billing for Telehealth

  1. What kind of devices can be used?
    1. Covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype.
    2. HIPAA Compliant communication products include Skype for Business, Updox, VSee, Zoom for Healthcare, Doxy.me and Google G Suite Hangouts Meet.
    3. Public facing applications such as Facebook Live, Twitch, TikTok, and other similar communications should not be used.
  2. Is Medicare waiving HIPAA Fines?
    1. Yes, covered health care providers subject to the HIPAA Privacy Rule may communicate with patients, and provide telehealth services, through remote communications technologies during the COVID-19 national emergency.
  3. Can I waive patient cost-sharing fees for telehealth visits?
    1. Yes, patient-cost sharing fees for telehealth visits can be waived during this national emergency time period.
  4. Will I get paid the same amount as in-person services?
    1. Yes, Medicare will reimburse at the same fee-schedule amount as in-person services.
  5. How long are these waivers in effect?
    1.  They will be in effect until the Public Health Emergency declaration is rescinded. At that time, policies will revert back to their original status.
  6. Do these policies include third-party payers?
    1. No, Check with your third-party payers and Medicare Advantage for requirements for telehealth reimbursement policies during this period.
  7. Can I ask Medicare patients to self-pay for telehealth services?
    1.  No, the Medicare statute requires that covered services for Medicare beneficiaries be billed to Medicare. Since Medicare Telehealth, virtual check-ins, and eVisits are all covered services, you must bill Medicare for these services when provided to a Medicare beneficiary.
  8. Can physical therapy provide telehealth services to Medicare beneficiaries?
    1. As of March 1, 2020, yes. Pursuant to interim final rulemaking, CMS will begin paying physical therapists and occupational therapists for Medicare telehealth visits and eVisits.

Other Payers' Telehealth Resources

Insurer Expanded Telehealth AccessCost-Sharing WaivedPlatforms Eligible Website
United HealthcareYes - Regardless of diagnosisYes

Apple FaceTime

Skype

Zoom

Dedicated Telehealth Applications

Link
Aetna Yes - Regardless of diagnosisYesNone ListedLink
Anthem Yes - Regardless of diagnosisYesNone ListedLink
Blue Cross Blue Shield Yes - Regardless of diagnosisYesNone ListedLink (Check with each BCBS company to find payer specific policies)
Humana Yes - Regardless of diagnosisYesNone ListedLink
Centene Yes - Regardless of diagnosisYesNone ListedLink
Molina Yes - Regardless of diagnosisYesTeladocLink
Cigna Yes - Regardless of diagnosisYesNone ListedLink
OscarYes - for COVID-19 Treatment OnlyYesOscar Telemedicine PlatformLink

 

 

AAOS Resources

AAOS COVID-19 Coding Guide

AAOS Telemedicine Policy Tracker

AAOS Telemedicine Resource Center

 

 

 State Resources

The Center for Connected Health Policy, an advocacy group for the adoption of telemedicine nationwide, has put together a helpful resource on the various state laws to keep in mind when providing telemedicine to patients. Access here.

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