Telehealth Coding for PT
Big news for PTs and their patients! For the first time, PTs will be allowed to bill for e-visits under codes associated with online assessment and management services (codes G2061, G2062, and G2063). To determine the reimbursement rates for G2061-G2063, visit the CMS Physician Fee Schedule lookup tool. Medicare coinsurance and deductible would apply to the services. A March 18 CMS MLN Matters article includes more information about the e-visits and telehealth waiver. Read below for more information!nnIn the federal government’s rapidly evolving response to the coronavirus pandemic, the U.S. Centers for Medicare and Medicaid Services has announced that it is easing Medicare telehealth restrictions in ways that could allow PTs to provide “e-visits,” a limited type of service that must be initiated by the patient. Prior to this change, CMS did not recognize PTs among the health care professionals allowed to bill codes associated with the visits.nnThe change, announced midday on March 17, is part of a set of loosened requirements that CMS has adopted to expand the provision of telehealth and patient-initiated digital communications, such as e-visits, to help blunt the spread of COVID-19. For the most part, PTs remain outside the reach of these so-called “1135 waivers” related to telehealth, with one exception: a type of remote interaction CMS calls an e-visit under Medicare Part B.nnIn its 2020 physician fee schedule final rule, CMS describes e-visits as “non face-to-face patient-initiated digital communications that require a clinical decision that otherwise typically would have been provided in the office.” The code descriptors suggest the codes are intended to cover short-term (up to seven days) assessments that are conducted online or via some other digital platform and include any associated clinical decision-making.nnUnder the waivers guidance issued by CMS, Medicare beneficiaries can qualify for e-visits no matter their geographic region or physical location, meaning that the provisions have been expanded to nonrural areas and can take place with patients in their homes. The big news for PTs and their patients is that, for the first time, PTs will be allowed to bill for e-visits under codes associated with online assessment and management services (codes G2061, G2062, and G2063). To determine the reimbursement rates for G2061-G2063, visit the CMS Physician Fee Schedule lookup tool. Medicare coinsurance and deductible would apply to the services. A March 18 CMS MLN Matters article includes more information about the e-visits and telehealth waiver.nnTo qualify as an e-visit, three basic qualifications must be met: the billing practice must have an established relationship with the patient, meaning the provider must have an existing provider-patient relationship; the patient must initiate the inquiry for an e-visit and verbally consent to check-in services, and the communications must be limited to a seven-day period through an “online patient portal.”nnAlthough the patient must initiate, CMS writes in a fact sheet that “practitioners may educate beneficiaries on the availability of the service prior to patient initiation.” For example, if a patient cancels treatment because they can’t come to the clinic or are concerned about leaving home, then the PT may advise the patient that she or her can reach out to the therapists as needed.nnAlice Bell, PT, DPT, APTA senior payment specialist, says that the waiver has some very practical implications for PTs, and offers a possible scenario in which the e-visit could be useful.nn”Let’s say that, as a PT, I’ve been seeing a patient for an orthopedic condition and I am progressing the patient’s exercises,” Bell said. “The patient is unable to come into the clinic but calls me to say she’s having difficulty with one of the exercises and that the other two seem to be too easy. I could arrange an e-visit with the patient and discuss her performance of the exercises. And I could then make a determination — maybe I find that the patient is performing one of the exercises incorrectly — and I could direct the patient on the correct performance. Perhaps I also determine that two of the exercises can be progressed because the patient is improving, so I could instruct the patient in the two new exercises. After that I could advise the patient to contact me for a follow-up e-visit as needed until the patient can return to the clinic.”nnThe HHS Office of the Inspector General has also issued a policy statement that provides guidance on how it interprets the new telehealth waivers. APTA regulatory affairs staff will continue to monitor these waivers and other developments and share news with members.nn”As we’ve seen over the past few weeks, and especially during the past few days, we’re dealing with an extremely fluid situation in terms of response to the coronavirus pandemic,” said Kara Gainer, APTA’s director of regulatory affairs. “This waiver and other changes have the potential to make a difference, and we hope that CMS continues to take steps that can help providers and their patients stay healthy.”nnAPTA has issued a statement on patient care and practice management during the COVID-19 outbreak, and offers a webpage to keep members up to date with the latest news on the pandemic.nnOriginal article published on apta.org
The COVID-19 pandemic is causing problems for everyone around the world. While it is important to pay attention to what is going on, there will be a point in time where everything will go back to normal. Many businesses will have buildup demand during this period and those that are ready to meet that demand will reap the rewards. Read the article below to find out what you need to do to prepare for life post COVID-19. nnPost COVID-19nCOVID-19 is all the buzz right now, but there will be a time after COVID-19 and when that time comes the winners will be those who are ready. No one, at least no one I know, wants to be sick or injured and need medical care, but it happens. Even during this pandemic, people will still need medical care, but the current slowdown, and even stoppage in some markets, of elective procedures, will create a buildup of demand for services. This pent-up demand will still be there as the impact of the virus diminishes and those practices that are ready to meet demand will reap the rewards.nnThings to consider as we weather this storm:n
So many of us are now faced with not only the challenges associated with working from home but having the whole family home as well. There are daily news stories about how to cope with kids who want to go see their friends, work-out routines without gym equipment, and virtual dance parties streamed live via social media. But as members of the health care industry, we must always keep the patient’s information as a top concern. Read below for more information!nnWhether you are working off your work computer hauled into your dining room or a laptop on the kitchen table there are steps you can take to make sure personal health information (PHI) stays secure. Just like being at the office make sure you are locking your computer every time you walk away. If you are talking on the phone make sure you are in a closed room where PHI cannot be heard by other members of your household. Keep your internet tabs to a minimum and close out all unnecessary programs while PHI is open.nnClick on the links below for information on working from home during COVID-19:nn
Welter Healthcare Partners is committed to keeping you up to date with the latest news regarding COVID-19. Beginning April 1st providers can start to use U07.1 for the diagnosis code of COVID-19. Read below to find out more about this coding update. n