![]() Medicare telehealth policies during the public health emergency Read the article about modifier CS and cost sharing here.List of covered CMS telehealth services. ![]() Resources to download regarding telehealth Read it for yourself in this MedLearn matters article. This is important! Using POS 02 or 10 for Medicare patients will result in lower reimbursement in 2023, thereby foregoing the payment parity CMS is allowing! Don’t believe me? POS 10: Telehealth Provided in Patient’s Homeĭon’t use POS 02 or 10 if you would have used POS 11 for the office service. POS 02: Telehealth Provided Other than in Patient’s Home There are now two telehealth POS codes but don’t start using them. The 2023 Physician Fee Schedule instructed practitioners to continue to use the POS that would have been used if the patient was seen in person. ![]() If POS 02 is used, it results in a lower payment, at the facility rate. If the patient would have been seen in the office, (POS 11) that results in a higher non-facility payment. What about payment parity? Medicare has told practitioners to use the place of service (POS) that would have been used if the patient was seen in person rather than POS 02 telehealth. The expanded list of practitioners continues and includes physical and occupational therapists, speech language pathologists, and audiologists.FQHCs and RHCs can be distant site providers of telehealth.For behavioral health audio-only visits, Congress delayed the implementation pre-requisite of an in-person visit.Medicare patients can continue to receive audio-only telehealth visits from practitioners.Medicare patients will continue to be able to receive telehealth in their homes, regardless of geographic location.The law does not require commercial insurances to follow these rules. Some, but not all of the flexibilities medical practices are used to having. 2022 extended some Medicare telehealth provisions until Dec. Question: What is happening to telehealth after the Public Health Emergency expires on May 11, 2023?Īnswer: The Consolidated Appropriates Act of 2023 passed by Congress in Dec. Virtual check in codes will only be allowed for established patients.Remote patient monitoring may be furnished only for established patients.Patients will be required to pay coinsurance for interprofessional consults and beneficiary consent will be required.For the teaching sites that practice under the primary care exception, levels 4 and 5 E/M services may not be provided by a resident alone.Virtual supervision of residents providing telehealth services will not be allowed in a metropolitan statistical area.Virtual supervision of residents will not be allowed in a metropolitan statistical areas.The DEA will require prescribers to see a patient face-to-face before administering controlled substances.During the PHE, practices were not required to collect the co-insurance/deductible although most did. Cost sharing requirements will be enforced.Telehealth platforms must be HIPAA compliant.After 5/11/23, if a practitioner is performing telehealth at home, they will be required to report their home address on the Medicare enrollment site.Question: What telehealth flexibilities expire on 5/11/23? Ĭoding for telehealth for Medicare after the PHE ends 5/11/23 Place of service: read this article on CodingIntel.Reimbursement for Q3014, originating site payment, will be $28.61.The Consolidated Appropriation Act of 2023 extended some telehealth flexibilities until 12/31/24. ![]() Starting 1/1/23, FQHCs and RHCs should use modifier 93 for audio-only visits, replacing modifier FQ.There is a new speaker symbol in the 2023 CPT book for services that CPT states can be performed via audio only, and these are listed in Appendix T. The AMA has developed a new modifier, -93 for audio only services.Congress passed a law in 2020 mandating that after the PHE ends, behavioral health services will continue to be allowed via telehealth, audio/visual and audio only.CMS will pay for audio only telehealth until Dec. CMS continues to pay for office visits via audio/visual communications (99202–99215) and office visits via audio only communication (99441–99443) during the pandemic.This article describes what will happen after the PHE ends Coding for telehealth is everchanging.
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