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March 2020 CMS Coding Update for Telehealth Services

March 2020 CMS Coding Update for Telehealth Services

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Telehealth Services Update

Effective for services starting March 6, 2020, the Coronavirus Preparedness and Response Supplemental Appropriateness Act, signed into law by President Trump, waives certain Medicare telehealth payment requirements during the Public Health Emergency (PHE); whereby, limitations on where Medicare patients are eligible for telehealth has been removed during this emergency (i.e., patients outside of rural areas, and patients in their homes will be eligible for the following telehealth services.

The new waiver authorizes the use of telephones that have audio/video capabilities for the furnishing of Medicare
telehealth services during the COVID-19 PHE. Also, they will waive penalties for HIPAA violations against healthcare providers that serve patients in good faith through everyday communications technology, such as FaceTime or Skype.

Billing Place of Service (POS)

For Medicare telehealth services, the claim should reflect the designated Place of Service (POS) code 02-Telehealth.

Telehealth Services Payment

Medicare pays the same amount for telehealth services as it would if the service was furnished in person. Deductible and coinsurance applies.

Provider Types Eligible to Provide These Services

  • Physicians
  • Nurse Practitioners
  • Physicians Assistants
  • Licensed Clinical Social Workers
  • Clinical Psychologists
  • Registered Dietitians
  • Nutrition Professionals

 

Quick Reference List: Telehealth Services Codes

  • G2010-G2012 Virtual check-in services
  • 99421-99423 Online digital evaluation and management (physician)
  • G2061-G2063 Online assessment by qualified nonphysician healthcare professional
  • G0425 Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
  • G0426 50 minutes communicating with the patient via telehealth
  • G0427 70 minutes communicating with the patient via telehealth
  • 99201-99215 Office and other outpatient visits
  • 99231-99233 Subsequent hospital care services, with the limitation of one (1) telehealth visit every 3 days
  • 9307-99310 Subsequent nursing facility care services, with the limitation of one (1) telehealth visit every 30 days
  • 97802-97804 Medical nutrition therapy
  • G0406-G0408 Follow-up inpatient consultation
  • G0513-G0514 Prolonged preventive services
  • G2086-G2088 Office-based treatment for opioid use disorder
  • G0420-G0421 Individual and group kidney disease education services
  • G0108-G0109 Individual and group diabetes self management training services, with a minimum of 1 hour
    of in-person instruction to be furnished in the initial year training period to ensure effective injection training
  • 96150-96154 Individual and group health and behavior assessment and intervention
  • 90832-90838 Individual psychotherapy
  • G0459 Telehealth pharmacologic management
  • 90791-90792 Psychiatric diagnostic interview examination
  • 90951-90961 ESRD-related services included in the monthly capitation payment
  • 90963-90966 ESRD-related services for home dialysis per full month
  • 90967-90970 ESRD-related services for dialysis less than a full month of service, per day
  • G0270 Individual and group medical nutrition therapy
  • 96116 Neurobehavioral status examination
  • 9406-99407 Smoking cessation services
  • G0396-G0397 Alcohol and/or substance abuse
  • G0442 Annual alcohol misuse screening, 15 minutes
  • G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
  • G0444 Annual depression screening, 15 minutes
  • G0445 Sexual behavior counseling, semi-annually, 30 minutes
  • G0446 Cardiovascular behavior therapy, 15 minutes
  • G0447 Obesity counseling, 15 minutes
  • 99495-99496 Transitional care management
  • 99497-99498 Advance care planning, 30 minutes
  • 90845 Psychoanalysis
  • 90846-90847 Family psychotherapy
  • 99354-99357 Prolonged services
  • G0438-G0439 Annual wellness visit
  • G0508 Telehealth consultation, critical care, initial, 60 minutes
  • G0509 Telehealth consultation, critical care, subsequent, 50 minutes
  • G0296 Lung Cancer Screening
  • 90785 Interactive complexity psychiatry services
  • 96160-96161 Health risk assessment
  • G0506 Chronic care management assessment
  • 90839-90840 Psychotherapy for crisis
  • G0513-G0514 Prolonged preventive services

 

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