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.
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.
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.
Medicare Telemedicine Health Care Provider Fact Sheet (CMS.gov)
AMA quick guide to telemedicine in practice
COVID-19: Telehealth billing 1-pager for Medicare, Medicaid and Commercials
COVID-19: ICD-10 Codes
COVID-19_CDC Printable instructions for patients
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