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Therapy Codes Update

26 May 2020 11:49 AM | Zachary Edgar (Administrator)

Issue Date: 5/26/2020

Effective Date: 6/16/2020

This article informs you of updates to the list of codes that sometimes or always describe therapy services. The additions to the therapy code list reflect those made in the Calendar Year (CY) 2020 for the COVID-19 Public Health Emergency (PHE). Please make sure your billing staffs are aware of these changes.

CMS is designating the below listed codes we’ve collectively termed as Communications Technology-Based Services (CTBS) as “sometimes therapy,” to permit physicians and NonPhysician Practitioners (NPPs), including nurse practitioners, physician assistants, and clinical nurse specialists to provide these services outside a therapy plan of care when appropriate. When provided by psychologists, licensed clinical social workers, or other practitioners, these CTBS codes are never considered therapy services and may not be reported with a GN, GO, or GP therapy modifier. When provided by therapists in private practice or therapists in institutional providers of therapy services, the CTBS codes are always provided under a physical therapy, occupational therapy, or speech-language pathology plan of care and must be reported with the associated GP, GO, or GN therapy modifier.

These three CPT codes, with their short descriptors, are added for telephone assessment and management services:

• CPT code 98966 (Hc pro phone call 5-10 min)

• CPT code 98967 (Hc pro phone call 11-20 min)

• CPT code 98968 (Hc pro phone call 21-30 min)

These five HCPCS codes, with their short descriptors, are added for remote evaluation of patient images/video, virtual check-ins, and online assessments (e-visits):

• HCPCS code G2010 (Remot image submit by pt)

• HCPCS code G2012 (Brief check in by MD/QHP)

• HCPCS code G2061 (Qual nonMD est pt 5-10 min)

• HCPCS code G2062 (Qual nonMD est pt 11-20 min) • HCPCS code G2063 (Qual nonMD est pt 21 min)

Reference

Centers for Medicare and Medicaid

MLN Matters Number: MM11791


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