During the COVID-19 public health emergency (COVID-19 PHE), CMS expanded the scope of telehealth\/ telemedicine services. In this blog, we shared telehealth billing guidelines that are applicable only for Gastroenterologists.<\/p>\n
CMS increased payment for telephone evaluation and management codes 99441-99443 to the level of office\/outpatient E\/M codes 99212-99214. These telehealth rules were expanded to all Medicare beneficiaries and included originating sites physician offices, skilled nursing facilities, and hospitals.<\/p>\n
These rules allowed two-way, real-time audio\/visual telehealth services to be paid under the Medicare Physician Fee Schedule at the same amount as in-person services for new as well as existing patients.\u00a0Hospitals and a range of clinicians, including doctors, nurse practitioners, clinical psychologists, nutrition professionals, and licensed social workers can provide telehealth.<\/p>\n
Medicare will allow audio-only telephone E\/M visits to be reported as telehealth, but they must be reported with the telephone E\/M codes 99441-99443. Only two-way, real-time audio\/visual E\/M visits can be reported using codes 99201-99215. In addition to traditional telehealth platforms, during the PHE CMS<\/a> will allow apps like FaceTime and Skype as acceptable platforms.<\/p>\n Please note that on July 19, 2021, the public health emergency was renewed for 90 days, expiring on Oct 18, 2021, which also includes the extension of the 1135 federal blanket waivers issued by CMS.<\/p>\n Medicare telehealth services include office visits and consultations, among other services, provided by an eligible provider using an interactive two-way telecommunications system with real-time audio and video or audio-only telephone. <\/span><\/p>\n Clinicians can report telehealth visits for both new and established patients on any real-time, non-public communication platforms, such as FaceTime and Skype, and sets payment the same as in-person E\/M visits during the COVID-19 PHE. <\/span><\/p>\n E\/M level selection can be based on medical decision making (MDM) or typical time listed in the CPT code description and CMS has temporarily removed any requirements regarding documentation of medical history and\/or physical exam in the medical record during the COVID-19 crisis.<\/span><\/p>\n Select the appropriate code (99201-99215) and use the place of service (POS) that would have been reported had the service been furnished in person (e.g., 11-Office, 22-Hospital Outpatient, 23-Ambulatory Surgery Center). <\/span><\/p>\n This will allow Medicare to pay for the service at the same rate that would have been paid if the service was furnished in person based on the provider\u2019s location (i.e., facility or non-facility). <\/span><\/p>\n Providers must also append telehealth modifier 95 to claim lines to identify that the service was furnished via telehealth. Providers who continue to use the general telehealth POS 02 code will be paid at the \u2018facility\u2019 rate.<\/p>\n CPT codes to describe telephone E\/M are time-based. Effective March 1, 2020, payment for telephone E\/M code 99441-99443 is equivalent to 99212-99214 and can be used for the new or established patients during the PHE. <\/span><\/p>\n Use modifier 95 and place of service (POS) where the visit would have taken place in person prior to the public health emergency (e.g., 11-Office, 22-Hospital Outpatient, 23-ASC). Check if your commercial payers pay for these services before reporting the codes for non-Medicare beneficiaries.<\/span><\/p>\n e-Consultations are interprofessional telephone, internet, or EHR provider-to-provider consultations. Code selection is time-based.<\/span><\/p>\n As mentioned earlier we shared telehealth billing guidelines that are applicable for Gastroenterologists. For detailed telehealth guidelines for your practice, you can refer to your commercial payer billing resources. <\/span><\/p>\n Medical Billers and Coders (MBC)<\/strong> is a medical billing company<\/a> that provides medical billing and coding services for various medical specialties. For Gastroenterology billing and coding services<\/a>, contact us at info@medicalbillersandcoders.com<\/a>\/ 888-357-3226.<\/strong><\/a><\/span><\/p>\n CMS expanded telehealth services, allowing audio\/visual visits to be billed at the same rate as in-person visits and increasing payment for telephone E\/M codes.<\/p> <\/div> Telephone evaluation and management services are reported using codes 99441-99443, which have been adjusted to match in-person E\/M codes 99212-99214.<\/p> <\/div> Yes, during the PHE, platforms like FaceTime and Skype are accepted for telehealth visits, allowing providers to connect with patients effectively.<\/p> <\/div> CMS temporarily removed the need for detailed documentation of medical history and physical exams during telehealth visits, simplifying the billing process.<\/p> <\/div> Providers must use the appropriate CPT codes, apply modifier 95, and indicate the place of service that would have applied if the visit occurred in person to ensure proper reimbursement.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":" During the COVID-19 public health emergency (COVID-19 PHE), CMS expanded the scope of telehealth\/ telemedicine services. In this blog, we shared telehealth billing guidelines that are applicable only for Gastroenterologists. CMS increased payment for telephone evaluation and management codes 99441-99443 to the level of office\/outpatient E\/M codes 99212-99214. These telehealth rules were expanded to all […]<\/p>\n","protected":false},"author":2,"featured_media":14137,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[393],"tags":[],"class_list":["post-14136","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gastroenterology-billing-services"],"yoast_head":"\nTelehealth Billing Guidelines<\/strong><\/h2>\n
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Telehealth Visits<\/strong><\/h2>\n
Telephone Evaluation and Management Service<\/strong><\/h3>\n
e-Consultations<\/strong><\/h3>\n
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FAQs<\/strong><\/h2>\n\n\n