Making Temporary Medicare Telehealth Coverage Permanent
In response to the public health emergency (PHE) for the COVID-19 pandemic, CMS undertook emergency rulemaking to add several services to the Medicare telehealth services list on an interim final basis, including communication technology-based services (CTBS).
CMS is now considering which of those services should remain on the Medicare telehealth services list permanently after the end of the PHE.
The good news is that CMS proposes adding the services in Table 8 on page 82 of the proposed rule (https://www.cms.gov/files/document/cms-1734-p-pdf.pdf) to the Medicare telehealth services list. Medicare is offering temporary additions to the telehealth services list for 2021. Check page 94 for the complete list.
Services CMS is proposing a permanent addition to the Medicare telehealth services list.
-Group Psychotherapy (CPT® code 90853).
-Domiciliary, Rest Home, or Custodial Care services, Established patients (CPT® codes 99334-99335).
-Home Visits, Established Patient (CPT® codes 99347- 99348).
-Cognitive Assessment and Care Planning Services (CPT® code 99483).
-Visit Complexity Inherent to Certain Office/Outpatient E/Ms (HCPCS Level II code GPC1X).
-Prolonged Services (CPT® code 99XXX).
-Psychological and Neuropsychological Testing (CPT® code 96121).
Services CMS is proposing as temporary additions to the Medicare telehealth services list.
-Domiciliary, Rest Home, or Custodial Care services, Established patients (CPT® codes 99336-99337).
-Home Visits, Established Patient (CPT® codes 99349-99350).
-Emergency Department Visits, Levels 1-3 (CPT® codes 99281-99283).
-Nursing facilities discharge day management (CPT® codes 99315-99316).
-Psychological and Neuropsychological Testing (CPT® codes 96130- 96133).
CMS also proposes to allow the billing of other CTBS by certain nonphysician practitioners (NPPs). New HCPCS Level II G codes have been added for practitioners who can’t bill for E/M services.
HCPCS Level II Code – Descriptor
G20X0 – Established patients can submit recorded videos and images for remote assessment. Our team will provide a follow-up within 24 business hours. Please note, this service cannot be related to a previous service received within the past seven days, nor can it lead to a service or procedure within the next 24 hours or the soonest available appointment.
G20X2 – Brief communication technology-based service, e.g., virtual check-in, by a qualified health care professional who cannot report evaluation and management services provided to an established patient. Not originating from a related e/m service supplied within the previous seven days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.
CMS proposes to value these services identically to HCPCS Level II codes G2010 and G2012.
CMS has put forth a new plan to assist therapists with billing for the CTBS. This plan identifies specific HCPCS Level II codes, such as G20X0, G20X2, G2061, G2062, and G2063, as “sometimes therapy” services. If a PT, OT, or SLP in private practice bills for these services, they must use the corresponding GO, GP, or GN therapy modifier to indicate that the CTBS is being provided as part of their care plan. Additionally, CMS proposes replacing the eVisit G codes with corresponding CPT® codes in CY 2021, which will also apply to these codes.
(Note from your Revenue Cycle Management partner at ebix, Inc. We are always at the forefront of industry insights and believe this announcement, Renee Dustman – Executive Editor at AAPC (American Academy of Professional Coders ), will interest you.)