Billing Medicare Telehealth During COVID-19 PHE

1
Billing Medicare Telehealth During COVID-19
PHE
2
Billing Medicare Telehealth During COVID-19 PHE
During the COVID-19 Public Health Emergency
(PHE), reimbursements for telehealth continue to
evolve. The federal government, state Medicaid
programs, and private insurers have expanded
coverage for virtual health care services. During
the COVID-19 public health emergency, any health
care provider who is eligible to bill Medicare
can bill for telehealth services regardless of
where the patient or provider is located. In this
article, we shared revised Medicare billing and
coding guidelines which will help in billing
Medicare telehealth during COVID-19 PHE. Changed
Telehealth Policies The federal government
announced a series of policy changes that broaden
Medicare coverage for telehealth during the
COVID-19 public health emergency. Legislation was
recently passed that gives a runway of 151 days
after the end of the PHE before any policy and
regulation changes take place. Some important
changes to Medicare telehealth coverage and
reimbursement during this period
include Location No geographic restrictions for
patients or providers Eligible providers All
health care providers who are eligible to bill
Medicare can bill for telehealth services,
including Federally Qualified Health Centers
(FQHCs) and Rural Health Clinics (RHCs)
3
Billing Medicare Telehealth During COVID-19 PHE
Eligible services See this list of telehealth
services from the Centers for Medicare Medicaid
Services Cost-sharing Providers can reduce or
waive patient cost-sharing (co-payments and
deductibles) for telehealth visits Licensing Prov
iders can furnish services outside their state of
enrollment. For questions about new enrollment
flexibilities, or to enroll for temporary billing
privileges, use this list of Medicare
Administrative Contractors (MACs) to call the
hotline for your area Modality The 2022
Physician Fee Schedule has codified the ability
for behavior health services to do audio only. It
is still required to complete an in-person
appointment every 6 months.
4
Billing Medicare Telehealth During COVID-19 PHE

• Billing for Medicare Fee-for-Service Claims
• More Medicare Fee-for-Service (FFS) services are
  billable as telehealth during the COVID-19 public
  health emergency. Medicare added over one hundred
  CPT and HCPCS codes to the telehealth services
  list for the duration of the COVID-19 public
  health emergency. You will find list of
  telehealth services covered by Medicare here.
  Telehealth visits billed to Medicare are paid at
  the same Medicare Fee-for-Service (FFS) rate as
  an in-person visit during the COVID-19 public
  health emergency.
• Coding Guidelines
• Telephone visits and audio-only telehealth
• Medicare increased payments for certain
  evaluation and management visits provided by
  phone for the duration of the COVID-19 public
  health emergency
• Telehealth CPT codes 99441 (5-10 minutes), 99442
  (11-20 minutes), and 99443 (20-30 minutes)
• Reimbursements match similar in-person services,
  increasing from about 14-41 to about 60-137,
  retroactive to March 1, 2020
• In addition, Medicare is temporarily waiving the
  audio-video requirement for many telehealth
  services during the COVID-19 public health
  emergency. Codes that have audio-only waivers
  during the public health emergency are noted in
  the list of telehealth services. Medicare is
  establishing new billing guidelines and payment
  rates to use after the emergency ends.

5
Billing Medicare Telehealth During COVID-19 PHE

• Place of Service codes and modifiers
• When billing telehealth claims for services
  delivered on or after January 1, 2022, and for
  the duration of the COVID-19 emergency
  declaration
• Include Place of Service (POS) equal to what it
  would have been had the service been furnished in
  person.
• Medicare hasnt identified place of service
  modifier 10 (PDF) for use when the patient is in
  their home. If they are located in any other
  location, utilize place of service modifier 02.
• Append modifier 95 to indicate the service took
  place via telehealth.
• The CR modifier is not required when billing for
  telehealth services.
• Hospital billing for remote visits
• Hospitals can bill HCPCS code Q3014, the
  originating site facility fee, when a hospital
  provides services via telehealth to a registered
  outpatient of the hospital. Under the emergency
  waiver in effect, the patient can be located in
  any provider-based department, including the
  hospital, or the patients home.
• Medisys Data Solutions is a leading medical
  billing company providing complete billing and
  coding services for various medical billing
  specialties. Our team of expert medical biller
  and coders are well versed with revised Medicare
  telehealth billing guidelines during COVID-19
  PHE. We can assist you in receiving accurate
  Medicare reimbursement for telehealth services.
  To know more about our Medicare telehealth
  billing services, contact us at
  info_at_medisysdata.com / 302-261-9187

6
(No Transcript)