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

· Physical, Occupational, and Speech therapists in private practice are eligible to bill Medicare for certain services provided via telehealth. [Editor’s Note: APTA is seeking confirmation as to whether services furnished by PTAs via telehealth are eligible for reimbursement.]

· Services that started as of March 1, 2020, and are provided for the duration of the public health emergency are eligible.

·These are some CPT codes are eligible to be billed: Evals, 97164, 97168, 97110, 97112, 97116. 97150-97158, 97530, 97535, 97542, 97750, 97761 – Speech S9152. See all codes in available link.

·Patients may be either new or established.

·These visits are for the same services as would be provided during an in-person visit and are paid at the same rate.

·Patients may be located in any geographic area (not just those designated as rural), and in any health care facility or in their home.

When billing claims for telehealth services provided on or after March 1, 2020, and for the duration of the public health emergency, bill with:

·Place of Service code equal to what it would have been had you furnished the service in person;

·Modifier 95, indicating that you did indeed perform the service via telehealth; and

·The GP modifier.

Cost-sharing will still be applicable. So this means that Medicare will pay the first 80% and the patient (or secondary) insurance is responsible for the 20% balance. Having said, if you waive the 20% you will not be sanction. (Once we are back to business per se, that will not be optional.)

HIPAA – At this time, CMS continues to be relaxed, but APTA is encouraging everyone to follow HIPAA guidelines when all possible. Do not use Facebook live or similar platforms, however, Facetime, Skype, etc are allowable.

Documentation – A LOT!
Keep in mind the documentation needed to have a proper compliant telehealth program. Be sure to document the type of technology you used for the evaluation or treatment including about obtaining and documenting informed consent.

You can access the complete release at: