COVID-19: Telehealth rules + billing/coding guide

To tackle the COVID-19 crisis, CMS has expanded its telehealth benefits on March 17th, 2020. I’ve synthesized the “must-reads” from the announcement below. For example, CMS will pay even if you Skype with patients.

KEY POINTS
There are three types of virtual visits: Telehealth visits, virtual checkins, e-visits.

Telehealth visits: Interactive audio/video real-time communications.

1/ Telehealth visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.

2/ Applicable in all types of settings across the country, including homes.

3/ No audits will be conducted to check if prior relationship existed for claims.

Virtual check-ins: Brief communications with providers, often initiated by patients. Any mode: phone or video or image.

1/ Applicable only for established patients.

2/ HCPCS code G2012: Usually a brief 5-10 minute medical discussion. HCPCS code G2010: Remote evaluation of recorded video or image submitted by the patient.

3/ Applicable across broad range of methods, unlike Telehealth that requires real-time audio/video.

E-Visits: Non-face-to-face patient-initiated communication with providers.

1/ Applicable only for established patients. No geographic restrictions.

2/ Communication via patient portals.

3/ Medicare co-insurance and deductibles would apply.

HIPAA:

1/ Authorities will waive penalties for HIPAA violations against providers that serve patients in good faith.

2/ FaceTime or Skype or other everyday communication tools are OK.

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References:

Medicare Telemedicine Health Care Provider Fact Sheet (CMS.gov)
AMA quick guide to telemedicine in practice

Download Resources:

COVID-19: Telehealth billing 1-pager for Medicare, Medicaid and Commercials
COVID-19: ICD-10 Codes
COVID-19_CDC Printable instructions for patients

You may also be interested in:

COVID-19: Resources for GI Practices

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By Praveen Suthrum, President & Co-Founder, NextServices. 

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