In part one of this post we covered some common questions related to telemedicine that have come up for many providers and clinics trying to figure out how to provide care for patients as COVID-19 has made in-person or face-to-face visits challenging or even unsafe in some areas. In part two we’ll cover some questions related to reimbursement and medical billing related to your telemedicine services.
Q: Are there codes to bill for COVID-19 telemedicine visits?
Yes. The American Medical Association has created a helpful online resource that outlines all the codes you can use for telemedicine visits, including codes for services applicable under COVID-19 (updated in May). It includes 26 different scenarios under which a patient might be seeking care, and all the applicable codes that you should use for various types of visits, including COVID-19-related visits, established patients, and new patients. It also has both CPT and ICD-10 codes, and links to CMS guidelines for more information.
Q: Are reimbursement rates the same for telemedicine as they would be for in-person visits?
Yes. While some telemedicine rates were previously lower than for in-person visits, during this current public health emergency, CMS has authorized payment for telemedicine that is the same as it would be for a face-to-face appointment, as long as it meets the criteria for an appropriate telemedicine visit.
In addition to those changes, Medicare has authorized practices to waive cost-sharing copays and deductibles as they deem necessary for telehealth services, and many preauthorization activities are on hold to allow more continuity of care for patients who need it. CMS published a full list of billing FAQs for reference. Commercial payers may have different rules or requirements, so it’s important to check with them to determine if they are following the CMS guidelines or have other reimbursement rates that you should be aware of as you are billing.
Q: What about lab billing for COVID?
COVID-19 testing is covered by CMS and by commercial (private) insurers. Since we are in a public health emergency (PHE), there are certain rules around the collection of specimens and billing for testing that you should be aware of. They also created new HCPCS codes for specimen collection depending on whether it is collected using a CDC test or another test. CMS published a full list of questions and answers about COVID laboratory billing services, including testing, on their website. CMS is also allowing diagnostic laboratory testing even if a patient has not seen a physician and received a written order, as long as the tests are conducted by a healthcare professional authorized to do so within the state. The full list of COVID-19 codes available are listed on CMS’ website.
Our telemedicine software from AdvancedMD can help your clinic continue providing services to your patients even during a difficult public health emergency. Find out more about our software by scheduling a demo today.