Navigating Telehealth Billing During COVID-19
State and federal officials, as well as commercial payers, have implemented numerous policy and regulatory changes in recent weeks to help practices implement more wide-spread telehealth services. To help practices make sense of it all, IMS has arranged for Katie Fergus, President of Des Moines-based PractiSynergy, provide an overview of both the national and state-specific billing and coding changes that have been implemented.
FCC Telehealth Support Program
The federal CARES Act provided $200 million for the creation of a COVID-19 Telehealth Program to support qualifying providers’ telecommunications, information services, and device expenses related to the provision of telehealth services. Applications for this rolling funding opportunity are now being accepted.
Centers for Medicare and Medicaid Services (CMS)
CMS Announces Expanded Telehealth Benefits for Medicare Beneficiaries
Proposed CY 21 Physician Fee Schedule Extends COVID-19 Telehealth Policies
CMS has published the proposed Calendar Year 2021 Physician Fee Schedule, which includes both permanent and temporary extensions of many telehealth coverage expansions and policy flexibilities that were initially implemented in response to COVID-19.
U.S. Department of Health and Human Services (HHS)
HHS Office of Civil Rights Easing Enforcement of HIPAA Standards for Telehealth Services
AHRQ COVID-19 Telehealth White Paper
The AHRQ Evidence-based Practice Center has published a new white paper using existing research to contextualize the rapid expansion of telehealth services during the COVID-19 pandemic and help inform clinical decision making.
Iowa Medicaid Enterprise (IME)
IME continues to release informational letters for billing services related to coronavirus and COVID-19 for both managed care and fee for service.
Wellmark has announced that it will waive telehealth credentialing standards, allow telephonic visits, and ensure payment parity for telehealth services.
Wellmark to Continue Paying Health Care Providers the Same for Virtual Visits Until Feb. 1 2021 (6/17/2020) - This applies to all appropriate medical and behavioral health virtual visits with any Wellmark in-network provider in Iowa.
UnitedHealthcare has announced it will waive telehealth originating site restrictions, cover select audio-only visits, and ensure payment parity for telehealth services. Effective May 11, 2020, UHC will require that telehealth visits with Medicare Advantage patients, including DSNP patients, be performed utilizing an interactive audio-video platform, unless otherwise indicated as a covered audio-only visit in the May 1, 2020, CMS telehealth announcement.
UnitedHealthcare Extends COVID-19 Temporary Telehealth Expansion and Cost Share Waivers - 6/17/2020
UnitedHealthcare is temporarily expanding the dates through which they are waiving the Centers for Medicare & Medicaid Services (CMS) originating site requirements for Medicare Advantage, Medicaid and Individual and fully insured Group Market health plan members.
Several partner organizations have developed resources to help practices understand the changing telehealth landscape. They have graciously allowed IMS to share these on this resource page.
Paramount Health Options
Paramount Health Options has assembled a telehealth billing and coding quick reference guide for commercial insurers.
Iowa Medical Group Management Association (IMGMA)
The IMGMA Payer Relations Committee has developed resources and assembled additional resources from their national partners to assist with telehealth information.
(Note: Due to Capacity, Live Webinars are Available Only to IMGMA Members; Recorded Webinars and Handouts are Available to Anyone)
Special Thanks to IMSF Support for This Page