Telehealth Services the New Horizon

Revenue from Telemedicine Services. The ongoing transformation in the Healthcare Industry right now is breathtaking. Despite the turmoil, as the economy re-opens, the anticipated benefits of new Telemedicine Services for providers and clinicians of all specialties is remarkable.    

The New Revenue Streams revolve around the following Telemedicine Visit Types already approved by CMS and followed by major commercial and private payers.  

The Public Health Emergency (PHE) declaration has generated a series of changes by CMS to the Telehealth Services to add even more flexibility to Telehealth Services so providers and clinicians can use to treat symptomatic and asymptomatic patients.

Of course, coding is key for reimbursements and to get those new revenue streams going. See chart below for more info on Billing Codes.

The following defines each Visit Type along with the new provisions under under the Public Health Emergency.  

Telehealth Visit Types

Telehealth Visit: a visit that uses telecommunication technology between a provider and a patient. This visit requires real time interactive video and audio electronic communication between provider and patient.  

Virtual Check-in: a Brief (5-10 minutes) check in with your practitioner via telephone or other telecommunication device to decide whether an office visit or other service is needed. Initiated by patient for established or new patients.

E-Visit: a communication between a patient and their provider through an online patient portal


Changes to Visits policies after PHE declaration

  • Clinicians can now provide more services to beneficiaries via telehealth so that clinicians can take care of their patients while mitigating the risk of the spread of the virus. Under the public health emergency, all beneficiaries across the country can receive Medicare telehealth and other communications technology-based services wherever they are located. Clinicians can provide these services to new or established patients. In addition, providers can waive Medicare copayments for these telehealth services for beneficiaries in Original Medicare.
  • Clinicians can also provide virtual check-in services (HCPCS codes G2010, G2012) to both new and established patients. Virtual check-in services were previously limited to established patients.
  • Licensed clinical social workers, clinical psychologists, physical therapists, occupational therapists, and speech language pathologists can provide e-visits. (HCPCS codes G2061-G2063).
  • A broad range of clinicians, including physicians, can now provide certain services by telephone to their patients (CPT codes 98966 -98968; 99441-99443)

Additional Temporary CMS Telehealth Services


Resources

Temporary changes for the duration of the Public Health Emergency. https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf

Complete list of all Medicare’s telehealth services and their corresponding billing codes. https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes


Key Takeaways

  • Waiver is temporary through duration of COVID-19 PHE
  • Expanded access for beneficiaries to telehealth services
  • Stay tuned to changes
  • Verify commercial and private payers’ coverage and policy.
  • Verify AMA telehealth codes are supported by Medicare’s
  • Be planning patient care approaches for post COVID-19 PHE.  

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