CMS breaks telehealth barriers for COVID-19: Home visits allowed, co-pays

Tuesday, March 24, 2020

by Julia Kyles, CPC, and Richard Scott 

 

Providers will find immediate opportunity to provide virtual visits to patients enrolled in Medicare plans as CMS seeks to facilitate screening and treatment of novel coronavirus (COVID-19) cases through telehealth services and implement billing guidance for these visits.

In a March 17 announcement, CMS said it would lift restrictions on providing most telehealth services to patients. For example, providers will be able to connect with Medicare patients in their homes or in other locations via face-to-face video technology. Previous rules limited providers and patients to specific “originating” and “distant” sites.

The HHS Office of Inspector General also said it would waive cost-sharing requirements for telehealth services. In a separate announcement the HHS Office of Civil Rights stated that it will waive penalties against providers who use apps such as Skype or FaceTime to perform telehealth services.

The new Medicare rules underscore CMS’ intentions to free up virtual-based visits as the COVID-19 pandemic spreads, adding to a March 10 announcement that enhanced access among Medicare Advantage carriers.

 

Six things you need to know

The waiver applies to all designated telehealth services and is effective March 6. Here are six things practices need to know before they start billing for telehealth services:

  • Practices will be able to bill telehealth encounters for any patient in any location. The designated area and originating site restrictions have been lifted.
  • Visits may be conducted with certain smartphones. The law lifted the restriction of telehealth visits by telephone if both the patient’s and the provider’s phones have audio and video capabilities and a real-time, two-way encounter is conducted.
  • The law limits the waiver to established patients, but HHS will not conduct audits to check a patient’s status.
  • You don’t have to charge a co-pay. The HHS Office of Inspector General announced that practices may waive the cost-sharing amounts for telehealth visits.
  • State law still holds sway. Check your state scope of practice to make sure your non-physician practitioners are allowed to provide telehealth services, and if so, which ones.
  • You may still report remote visits such as online digital E/M visits and virtual check-ins.

 

Editor’s note: This article was adapted from Part B News.  

NAHRI members can share information and ask questions about COVID-19-related revenue integrity concerns on our dedicated COVID-19 forum. Nonmembers may use HCPro’s COVID-19 forum by registering free of charge. Visit our Coronavirus Resource Center for additional guidance and education. Email NAHRI Director Jaclyn Fitzgerald at jfitzgerald@hcpro.com with requests for additional COVID-19 resources and news. 

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