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Telehealth Insurer Coverage

Telehealth Pay: Insurers Extend Dates

QUESTION: Our patients have really responded to the telehealth services that we introduced to help extend care during the height of COVID-19. We still provide more than 50% of our services via telehealth. Are payers going to extend the telehealth waivers, or will it become more difficult to provide these virtual services? Milwaukee, WI Subscriber […]

CPT Code 99443 Reimbursement: New CMS Rules for 30 Min Calls

You can add thousands of dollars in revenue for your telephone calls (99441-99443) thanks to new CMS rules. Pre-coronavirus, these codes netted a big fat $0. But now Medicare is paying up to $110 for a 30-minute call if you get your billing right. To capture this added payment fast without facing improper claims penalties, […]
CPT Code 99211 Telehealth

CPT Code 99211: Get $23 Per Patient on Nurse Telehealth

New CMS rules have expanded your reimbursement opportunities for new patient and telehealth services your registered nurses and medical assistants previously provided for free. The catch is, that if you want to be paid you must know exactly when and how to accurately apply CPT code 99211. Follow these updated Medicare eligibility and incident to […]
restarting elective surgery after covid-19

2 Policies Restart Your Elective Surgeries Post Coronavirus

Your practice’s financial stability means you have to quickly scale your elective surgeries back to pre-coronavirus days while complying with new safety guidelines. Two of the top policies you need to iron out and then communicate are your pre-surgical COVID-19 screening processes and surgery visitation allowances. As you create and implement your new COVID-19 surgical […]
CPT code telephone 99443

30-Min Call Now Pays $110

QUESTION: Medicare already covers a physician telephone call with G2012. With the recent virtual care coding changes, should I now use 994xx instead? Subscription question from Bangor, Maine ANSWER: CMS made CPT telephone call codes (99441-99443) payable as of March 1, 2020, and increased their reimbursement to make them equivalent to mid-level established patient office […]
HIPAA Violations Zoom

Use Zoom Judiciously or Face Lawsuit

QUESTION: We heard that HIPAA allowed any technology for telehealth exams during the pandemic.  While researching the options, Zoom was a low barrier entry due to low monthly cost and single sign on function. We have read reports of some companies banning the technology because of security issues. However, we’ve also read that during this […]
Cost Sharing Waivers

Avoid COVID-19 Fraud: Comply with Cost Sharing Waivers

CMS and private payers have recently implemented a variety of prior-authorization, copay and cost-sharing billing waivers for the COVID-19-related services you supply to your patients. Many of the services included in these waivers are being made available to patients at no cost. This helps prevent the inability to pay for services as a barrier to […]
telehealth incidentto hospital

Get Paid for Remote Services for Your Hospitalized Patients

QUESTION: We are really confused on the constant telehealth regulatory changes. Our providers understand that new codes qualify with less supervision – and even without audio. We have several elderly patients who require ongoing care. Can you provide us with some recent options for CMS paid telehealth so we can continue to care for our […]

New CMS Telehealth Rule: Speed Cashflow, Update Billing

Just when you thought you got your head semi-wrapped around Medicare telemedicine rules, they go and throw it out the window! On March 30, CMS issued an Interim Final Rule and released new guidance on how to code and bill for rapidly evolving telehealth services. Before you file another claim, here are the three sweeping […]

Claim Denial Telehealth: Check 2 Items Before Refiling

QUESTION: How can we avoid denials for telehealth claims including modifiers? We just received our first denial for a telehealth service using audio-visual. The claim was filed with office visit code 99212, place of service 02 for telehealth and modifier 95. Can you tell us what we did wrong so that we can get paid […]