The rapid evolution of telehealth services has helped keep medical practice virtual doors open to meet their patients' health needs during the pandemic. But with new utilization comes cautionary areas from a billing standpoint, and it's important to stay current on updates and compliance protocols to promote revenue growth and avoid financial loss.
Will they stay or will they go? Telemedicine flexibilities post-pandemic?
CMS published the Final Physician Fee Schedule Rule in the Federal Register last year to include certain telemedicine flexibilities, some permanent and others extended for the remainder of the year in which the public health emergency (PHE) ends. The 1135 waiver expanded coverage for office, hospital, and other visits furnished via telecommunications and information technology - including in the patient's place of residence.
Presently, Medicare telemedicine covered services include:
- Added permanent coverage for a range of services, such as group psychotherapy, low-intensity home visits, and psychological and neuropsychological testing.
- Temporary coverage for certain services through the end of the calendar year in which the COVID-19 PHE ends, such as high-intensity home visits, emergency department visits, specialized therapy visits, and nursing facility discharge day management
- Finalized services covered on a temporary basis during the PHE that it will not cover on a permanent basis once pandemic ends: These include telephonic evaluation and management services, initial nursing facility visits, radiation treatment management services, and new patient home visits.
- The 30-day frequency limit for subsequent nursing facility visits provided via telemedicine was revised to 14 days.
- It accepted more providers including licensed social workers, clinical psychologists, physical therapists, speech-language therapists can now bill for telemedicine for online assessments and management services, virtual check-ins, remote evaluations. CMS added new codes for these services—a major advantage depending on your specialty.
These changes have been good news for many medical specialties that could not offer telemedicine previously and medical practices that were limited in telemedicine services as they can now provide an alternative to in-person patient care.
Attend Tips for Proper Telehealth Billing and Coding to stay current on these changes and how they impact your practice.
Know the Guidelines and Audit Your Clams to Avoid Revenue Loss
With policy changes and an increase in utilization in any service (including medicine), payor audits will follow. Practice Management Trainer/Consultant Maxine Collins says we must all stay current on payer guidelines and changes, and carefully monitor documentation, services, and claims submissions for accuracy.
There are lots of questions about what services will be extended during this third wave, and what telephone codes will CMS continue to reimburse after the pandemic? How long will CMS pay for services that appear on the list of temporary Category 3 services?
Maxine says Medical practices shouldn’t wait for an audit to uncover compliance errors. While the policy and payment landscape surrounding telehealth remains complex, your medical documentation must substantiate all medical visits. Having a compliance plan and self-auditing along the way will not only help a successful audit but will also keep your practice organized and improve operations.
Stay Current on Telehealth & Other Practice Management Updates
We are all waiting for news to drop about the fate of telehealth services after the end of the public health emergency. Keeping abreast of important changes happening during and post-pandemic will help keep your claims and denials in check. Join Maxine Collins for a live webinar on September 23: Tips for Proper Telehealth Billing and Coding, for detailed instruction on how these services are properly documented and reported, and learn more about the evolving rules that govern how these services are paid.
When your practice is armed with the latest information available, you will be better prepared to secure accurate reimbursement for your providers.