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Telehealth Changes After the COVID-19 Public Health Emergency: What You Need to Know

4/6/2023

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The COVID-19 pandemic has made telehealth more popular and accessible than ever before. But not all telehealth changes that were implemented during the public health emergency (PHE) will last forever. Some will expire when the PHE ends on May 11, 2023, while others will continue until December 31, 2024 or beyond.

Behavioral Health Services
During the PHE, Medicare expanded coverage of behavioral health services via telehealth. For example, Medicare allowed Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to provide behavioral health services via telehealth as distant site providers, waived geographic and location restrictions for originating sites for behavioral health services, and permitted audio-only communication platforms for behavioral health services.
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Some of these changes are permanent or extended until December 31, 2024. However, some changes will expire when the PHE ends. For example, Medicare will revert to its pre-PHE list of telehealth services, which means that some behavioral health codes that were added during the PHE will no longer be covered by Medicare via telehealth. Also, Medicare will reinstate the requirement for an in-person visit within six months of an initial behavioral health telehealth service, and annually thereafter, with any provider of the same group and specialty.

Place of Service Codes
During the PHE, Medicare instructed providers to use place of service (POS) code 11 (office) for telehealth services provided to patients in their homes or other locations, instead of POS code 02 (telehealth), which would normally apply for telehealth services. This was done to ensure that providers would receive the same payment rate for telehealth services as they would for in-person services.
Medicare also created a new POS code 10 (temporary lodging) for telehealth services provided to patients who are temporarily located outside their home state or county due to a federally declared emergency or public health emergency.
These changes will remain in effect until December 31, 2024. After that date, Medicare will resume using POS code 02 for telehealth services and discontinue using POS code 10.

Audio-Only Services
During the PHE, Medicare allowed certain telehealth services to be delivered using audio-only communication platforms when the patient does not have the ability for audio and video. This was especially helpful for patients who had limited access to technology or internet connectivity.
This allowance will also expire when the PHE ends, except for behavioral health services, which can continue to be delivered using audio-only platforms until December 31, 2024.
Teaching Physician Supervision
During the PHE, Medicare allowed teaching physicians to virtually supervise residents using real-time audiovisual communication when they provide telehealth services to Medicare beneficiaries until the end of the PHE.
This change will also expire when the PHE ends, except for telehealth services provided by residents in rural areas, which can continue to be virtually supervised by teaching physicians after the end of the PHE.

Billing Rules
During the PHE, Medicare allowed nurse practitioners (NPs) and physician assistants (PAs) to provide and bill for telehealth services under the direct supervision of a physician who is virtually present using real-time audiovisual communication until the end of the PHE.
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This change will also expire when the PHE ends. After May 11, 2023, NPs and PAs will need to bill for telehealth services under their own enrollment or under the general supervision of a physician who is not required to be virtually present.

Conclusion
Telehealth has been a lifeline for many patients and providers during the COVID-19 pandemic. But not all telehealth changes that were implemented during the PHE will last forever. Some will expire when the PHE ends on May 11, 2023, while others will continue until December 31, 2024 or beyond. To stay updated on telehealth policy changes, please visit https://telehealth.hhs.gov/ and https://www.cms.gov/.



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Get Ready for 2023 Evaluation and Management Changes

7/12/2022

 
The 2021 Evaluation and Management Changes to the Office and Other Outpatient categories was the beginning of many changes to streamline physician documentation and coding, and eliminate “note bloat”.
 
The 2023 CPT will continue to address facility categories of Evaluation and Management including Inpatient Hospital, Observation, Nursing Facility, Home or Residence Services and deletes codes in the Observation, Domiciliary, Rest Home and Assisted Living sites of service.
 
There are new Prolonged Services Codes, and new guidelines for their use.
 
Important changes will be made when a patient is admitted to the hospital in the course of an encounter in another site.  The longstanding “One E/M per patient per day” rule has been updated. 
 
Plan to schedule a webinar or onsite group training this fall.  Call us today to schedule a time for your providers, billers, coders, administrators, and clinical staff.  Everyone in your practice should know about these changes.
 

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CPC Classes

7/13/2021

 
Unfortunately until further notice CPC courses are being discontinued.  Due to the rising cost of running the class and a low number of students, we are are not able to continue offering the classes.  Contact your local AAPC chapter for a list of classes or exams in your area.  Thanks for your understanding.  

2021 Spring CPC Class- Postponed

1/5/2021

 
The public health emergency caused by COVID-19 has made planning and carrying out live, instructor-led coding courses incredibly difficult.  The 2020 Spring course was interrupted by the public health emergency, and ultimately was postponed to the fall.  The 2020 Fall course just recently wrapped up after it was shuffled around a bit due accommodate state shut-downs.  With the New Year, we have had a lot of questions about whether the Spring 2021 class will go on as planned.  We have decided not to run a Spring course this year.  We may still opt to put on a Fall course in September.  If not, we may decide to move the Fall course to online-only, or postpone it altogether.
 
Sorry for the inconvenience to all those who have expressed interest this year, but thank you for your understanding.

Podcast: Telehealth Facts for the Current COVID-19 Event

3/25/2020

 
Nancy Enos was recently a guest on a podcast that is available now!  This podcast is for medical practices to address CMS Telehealth rules for the current COVID - 19 event. For more information visit http://covid19.libsyn.com/website
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    Mike and Nancy are independent consultants and coding educators.  They are a mother/son team who are active in local and regional professional organizations.

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