In response to the rapidly evolving situation with COVID-19, MedConverge’s dedicated COVID team is now available round the clock to answer all your coding and billing questions. Ask Us
Here are some excerpts from the Medicare Fact Sheet on CMS coverage guidelines for telehealth services dated 03/05/2020:
Telehealth and Other Communication-Based Technology Services
Beneficiaries can communicate with their doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit.
Since 2018, Medicare pays for “virtual check-ins” for patients to connect with their doctors without going to the doctor’s office. These brief, virtual check-in services are for patients with an established relationship with a physician or certain practitioners where the communication is not related to a medical visit within the previous 7 days and does not lead to a medical visit within the next 24 hours (or soonest appointment available). The patient must verbally consent to using virtual check-ins and the consent must be documented in the medical record prior to the patient using the service. The Medicare coinsurance and deductible would apply to these services.
Doctors and certain practitioners may bill for these virtual check-in services furnished through several communication technology modalities, such as telephone (HCPCS code G2012) or captured video or image (HCPCS code G2010).
Medicare also pays for patients to communicate with their doctors without going to the doctor’s office using online patient portals. The individual communications, like the virtual check ins, must be initiated by the patient; however, practitioners may educate beneficiaries on the availability of this kind of service prior to patient initiation. The communications can occur over a 7-day period. The services may be billed using CPT codes 99421-99423 and HCPCS codes G2061-G2063, as applicable. The Medicare coinsurance and deductible would apply to these services.
At MedConverge, our team is equipped with a thorough understanding of the changes in medical billing and coding with respect to COVID-19. If you have any questions or need additional information, contact us on: firstname.lastname@example.org