TeleMedicine Update and Billing Overview

What do we know today? 03-21-2020
While CMS has eased many of the restrictions on Telemedicine use and billing. It’s important to remember that most commercial payors have not adopted CMS’ relaxed approach.
1. Payors may be expanding coverage for more professionals to use and incorporating into more plans as a benefit, but many of their policies requirements for delivery of the service remain the same.
a. For instance, Medicare Telemedicine does not have to be HIPAA Compliant during the waiver, such as Facetime, Skype, and Duo. However, many private payors still require that a provider’s platform remains HIPAA Compliant. Please verify your patient’s benefit for the service and be aware of the technology you are using.
We suggest using OneTouch Telehealth. Use these links to view the registration and demo. OneTouch Demo OneTouch Registration
b. When billing Medicare, continue using your regular office visit codes 992** and append modifier GQ and use POS 02. When billing commercial payors, continue using your regular office visit codes 992** and append modifier 95 with POS 02. Remember, this is what we know today and you may experience some variances. Please tell us what you learn.
c. Medicare is allowing New Patients to be established under this waiver period and only during this waiver period. As of this writing, The waiver period is retroactive to March 6, 2020 and no end date is currently published.
2. If you choose to stay offsite, your checks go to the office and not your home, ask your local post office to hold your mail, and pick it up at regular intervals.
3. Do not have your mail forwarded. You run the risk of some carriers, particularly Federal, having a do not forward order. Your mail will be returned to them and you will later have to reinstate your mailing address with proof.
4. Changing your reimbursement/correspondence address is not a good idea at this time. There is usually a 90 day turn around for this and it will probably take much longer during this crisis.
5. Setting up electronic reimbursement and electronic remittance advice (eobs) is a good idea at all times, although delays are likely to occur.

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