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Expansion of Medicare Telehealth Services PT, OT Home Health

May 2, 2020

On April 30 CMS announced it will allow physical and occupational therapists to perform services through telehealth.  Previously, Medicare had authorized therapy codes but did not include therapists has telehealth providers.   

Physical and occupational therapy codes

97110; 97112; 97116; 97150; 97161; 97162; 97163; 97164; 97165; 97166; 97167; 97168; 97530; 97535; 97542; 97750; 97755; 97760; 97761

Home health codes

99341; 99342; 99343; 99344; 99345; 99347; 99348; 99349; 99350

Speech-language pathology codes

92507; 92508; 92521; 92522; 92523; 92524; 92601; 92602; 92603; 92604

Place of Service Codes

Do not use 02 to bill for telehealth.  Use your normal POS code, even if providing services from your home.

11: Office

12: Home

13: Assisted Living

19: Off-Campus Outpatient Hospital

20: Urgent Care Facility

21: Inpatient Hospital

22: On-Campus Outpatient Hospital

31: Skilled Nursing Facility

32: Nursing Facility

61: Inpatient Rehab Facility

62: Outpatient Rehab Facility

Modifiers

Use modifier 95 to indicate services were done through telehealth.  Do not use modifier GT.

Use GP and GO, respectively.

Patients

Patients may be new or established.

Assistants

It is unclear if telehealth services can be performed through telehealth. 

Communications

Services must be provided in real-time (synchronous), audio and visual communication must be established with the patient.

Technology - HIPAA

During the Covid-19 emergency, providers may use programs like Skype or Apple FaceTime.

Duration

Therapists can bill retroactively from March 1 until the end of the emergency period.

Outpatient Hospitals

Hospitals may bill for services furnished remotely by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is at home when the home is serving as a temporary provider based department of the hospital. Examples of such services include counseling and educational service as well as therapy services.

Skilled Nursing Facilities

Therapists can use telehealth to treat patients in SNFs.

Reference

Trump Administration Issues Second Round of Sweeping Changes to Support U.S. Healthcare System During COVID-19 Pandemic

CMS-1744-IFC


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