by Gail I. Smith, MA, RHIA, CCS-P
A Medicare Telemedicine Health Care Provider Fact Sheet was released by CMS on March 17, 2020. Link: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
CMS is expanding telemedicine benefits with a 1135 waiver that will pay for office, hospital and other visits furnished via telehealth starting with March 6, 2020 and lasting for the duration of the COVID-19 emergency. Medicare beneficiaries will be able to receive services including evaluation and management (E&M), mental health counseling and preventive health screenings. CMS identifies three main types of virtual services and provides billing guidance and specific codes to report services. Included in the Fact Sheet are Key Takeaways and the following table that summarizes the program.
|Type of Service||What is the Service?||HCPCS/CPT Code||Patient Relationship with Provider|
|Medicare Telehealth Visits||A visit with the provider that uses telecommunication systems between a provider and a patient||Common telehealth services include: |
For a complete list:
|For new* or established patients |
*To the extent that 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency
|Virtual Check-in||A brief (5-10 minutes) check-in with your practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed. A remote evaluation of recorded video and/or images submitted by an established patient.|| ||For established patients|
|E-Visits||A communication between a patient and their provider through an online patient portal.|| ||For established patients|
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