Telehealth

Expanded Telehealth Guidelines

  • CMS telemedicine expansion to all areas as well as allow new patient visits under Telemedicine
  • HIPAA Restrictions Suspended
    • Allowing for everyday communication technologies (e.g., Skype, Google Hangouts, etc.)
  • Temporarily suspended parts of Texas Occupation Code and Texas Administrative Code for Telemedicine.
    • To include the use of telephone only
  • Cost-Share Waived or Reduced
    • Waiving patient cost share on COVID-19 testing and telehealth visits.

User Guides for Practices and Patients

  • User Guide: Accessing Doxy.me for Virtual Visit (PDF)
  • User Guide: How to check in as a patient on Doxy.me (Web/Video)
  • User Guide: Joining a Skype Meeting (Video PDF)
  • User Guide: Billing-Virtual Visit via Telephone Encounter (PDF)

SWHR QPIP Medicare Telemedicine Attestations

Attestations

  • Required to be a Medicare Telemedicine Visit — A service that would generally be conducted face to face (e.g., office visit), but is furnished via an interactive audio and video telecommunications system that permits real-time communication between a patient and their provider.
  • Workflow Recommendation
    • Download, print, complete, return Attestations for Medicare Telemedicine Visits the same way they would for a face-to-face office visit.
    • Schedule/reschedule appointments.
    • Attestations completed for Medicare Telemedicine Visits will be counted towards QPIP.
  • Required Documentation
  • Medicare and Medicare Advantage (MA) Telemedicine — Medical Documentation Guidance

Coding Telemedicine

Medicare and Medicare Advantage Plans

  • New Video Available on Medicare Coverage and Payment of Virtual Services CMS has released a video providing answers to common questions about the Medicare telehealth services benefit. View video.

Commercial Plans

  • For commercial payers, see individualized policies on the COVID-19 Telemedicine Payer Information page.
    • BCBS, Cigna, UHC and Humana have confirmed audio-only E&M visits (​i.e., 99201-99205/99211-99215, as well as all other Telemedicine Codes) can be billed during the Public Health Emergency (PHE) with applicable modifier and Place of Service (POS). Please ensure documentation meets same standards as face-to-face visits. (Note: Aetna requires audio-only visits to use G2012 or 99441-99443 only.)
    • BCBS, Aetna, Cigna, UHC and Humana have all confirmed to use place of service that would have been reported had the service been furnished in person (i.e., POS 11) in order for the claim to process at normal in-office rate.
    • Telephone calls that do not meet documentation standards please bill with appropriate telephone codes if applicable. Telephone codes provide by a physician to an established patient, parent or guardian not/nor:
      1. Originating from a related E/M service provide within the previous seven days.
      2. Leading to an E/M service or procedure within the next 24 hours or soonest available appointment.

Medicaid and Managed Medicaid

  • Audio Only New and Established E&M utilizing the modifier 95 available March 20-April 30

Procedure Codes

90791907929083290833908349083690837908389095190952
90954909559095790958909609096199201992029920399204
99205992119921299213992149921599241992429924399244
99245992519925299253992549925599354993559935699357
G0406*G0407*G0408*G0425G0426G0427G0459

*Procedure codes are limited to one service per day.

  • Telephone evaluation and management service provide by a physician to an established patient, parent or guardian not/nor:​
    1. Originating from a related E/M service provide within the previous seven days.
    2. Leading to an E/M service or procedure within the next 24 hours or soonest available appointment.

Billing and Reimbursement

Documenting Telehealth

  • How to Document a Virtual Visit in eClinicalWorks (Video | PDF)
  • Documenting Virtual Visits in eCW via Resource Schedule (Video | PDF)
  • User Guide: Documenting Telehealth Visits in eCW (PDF)