CMS released another important update to the ever-evolving emergency telemedicine rules. As ClaimCare has explained in earlier posts during the COVID-19 crisis, one thing is certain: “As we learn more, more things change.” This stands true with the eligibility, coding and claims processing for telemedicine. ClaimCare has highlighted some key points for you that include the latest changes from today’s CMS update. The current CMS report titled Physicians and Other Clinicians: CMS Flexibilities to Fight COVID-19 lists all the CPT codes that CMS is now allowing due to the National Health Disaster.
Key Points that Make Telemedicine Easier and Better
- Removes barriers for physicians, nurses and other clinicians to be readily hired from the community or from other states so the healthcare system can rapidly expand its workforce.
- Increase access to telehealth in Medicare to ensure patients have access to physicians and other clinicians while keeping patients safe at home.
- Puts patient care FIRST before paperwork to give temporary relief from the many reporting and auditing requirements, allowing providers, healthcare facilities, Medicare Advance and Part D plans and States to focus on providing needed care to Medicare and Medicaid beneficiaries affected by COVID-19.
- Allows clinicians to now provide these services to established and new patients.
- Allows ANY kind of telemedicine service (see attached list of CPT codes to use).
- Removes Frequency guidelines.
- Where a face-to-face visit was required in the past, those guidelines do not apply during the national health emergency.
- Supervision requirements will not apply during the crisis, but Supervision where previously required will be allowed via teleconference with the Supervising Provider.
- Postpones ALL re-validation requirements.
Very importantly, CPT Codes have changed and expanded (again)! There are numerous codes that can now be billed via Telehealth that could not previously be billed. It is imperative when documenting in your systems you notify medical billers that you provided these services via telemedicine. Medical billers are required to use the appropriate place of service as well as the correct modifiers.
ClaimCare recommends you indicate in the visit type that (1) it is a telehealth visit (2) you have obtained verbal consent from the patient and (3) consent is documented in the chart. Although the current CMS report articulates the suspension of audits, we encourage you to complete the documentation that you normally would and are ABLE to complete in the chart during the telemedicine visit.
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