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Video visits healthcare1/17/2024 Audio-only encounters can be provided using the telephone evaluation and management codes (CPT codes 99441-99443).ĬMS has updated the documentation requirements for outpatient E/M services delivered via telehealth. Medicare requires audio-video for office visit (CPT 99201-99215) telehealth services.The requirements for Medicare Advantage members align with Medicare’s policy (below). UHC will allow audio-only visits telehealth services for Medicaid and commercial patients.Aetna will cover minor acute care services delivered via audio-only.Physicians should determine whether they can complete all required elements of their normal E/M service via audio only or whether the services should be submitted as a telephone E/M code. The applicable coding requirements must be satisfied for the visit.These visits should be coded as a typical telehealth visit as outlined above. Some payers are allowing practices to provide telehealth office visits to provide using audio-video or audio-only communications. Cost-sharing waivers may not be applied to claims that do not include an appropriate COVID-19 ICD-10 diagnosis code. Coding guidance can be found on the CDC website. Items and services must be related to the furnishing or administration of the test or to the evaluation of the patient for the purposes of determining the need for a COVID-19 test.ĬOVID-19-related services should be assigned the appropriate COVID-19 ICD-10 diagnosis code. Items and services furnished to an individual through office visits (in-person and telehealth), urgent care center visits, and emergency room visits that result in an order for or administration of a COVID-test.other tests the secretary of HHS determines appropriate in guidance.a test that is developed in and authorized by a state that has notified the secretary of Health and Human Services (HHS) of its intention to review tests intended to diagnose COVID-19 or.The test must be approved, or the developer has requested or intends to request emergency use authorization under the Federal Food, Drug, and Cosmetic Act An in vitro diagnostic test for the detection of SARS-CoV-2 or the diagnosis of COVID-19.Claims missing the “CS” modifier may not be paid at the full allowed amount. The “CS” modifier is required to trigger full payment of the allowed amount. Medicare and most national payers will pay the full contracted/allowed amount when cost-sharing is waived. Some payers are automatically reprocessing claims that were submitted with the “POS 02 – Telehealth.” Contact your provider relations representative to verify if the payer is automatically reprocessing claims or if you will need to resubmit claims.Claims with “POS 02 – Telehealth” may be paid at a lower rate. Practices should use the POS they would have used if the service had been provided in-person. Office visits provided via telehealth will be paid at the same rate as in-person visits when the appropriate POS is used. Telehealth services can be provided to all patients regardless of originating site, including patients at home. Originating site restrictions have been lifted. Telehealth services can be provided to new and established patients via smartphone if the smartphone allows for audio-video interaction between the physician and patient. Check with your provider relations representatives for each payer’s telehealth policy and covered telehealth services. Private payers vary on covered telehealth services. A full list of Medicare telehealth services is available here.
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