Earn $110 For Patient Phone Calls, New CMS Rule Applies

Clear

Your practice’s 30-minute phone calls (99443) can now be paid at $110 – the same amount as a level-4 office visit (99214). But to get the added reimbursement you must successfully meet CMS’ April 30th requirements.

Payments for telephone calls (99441-99443) have jumped to $46-$110 from $14-$41 making telephone E/M service reimbursement now equivalent to mid-level office visits (99212-99214). The increased payments are applicable to claims from March 1.

With a little help you can seriously boost reimbursement for your patient phone visits, and coding and training expert, Leonta (Lee) Williams, MBA, RHIA, CCS, CCDS, CPC, CPCO, CEMC, CHONC, CRC, can tell you how. During Lee’s online training, she’ll will walk you through how to comply with the most recent telehealth coding rules, so you can get paid more of what you deserve for your patient phone visits and other telehealth services.

Here are just a few of the proven telehealth and virtual care coding and billing questions you’ll get answered by attending this practical, 60-minute online session:

  • What Place of Service code do telephone call codes (99441-99443) now require?
  • What providers are eligible to use 99441-99443?
  • If you were paid the prior rates for 99441-99443, can you collect the additional pay?
  • What new codes now qualify for telehealth coverage?
  • Do you need CR/CS modifiers PLUS modifier 95 on all telehealth claims?
  • Should all virtual claims lacking new modifiers be refiled?
  • What counts as a “confirmed” COVID-19 related diagnosis?
  • Does audio count as synchronous for some private payers?
  • Can you use telemedicine codes if your provider communicates with patients behind plexiglass?
  • What payers still want a Place of Service of 02?
  • Can drive-thru testing be billed with virtual care codes?
  • Should you list the provider’s home address when the distant site is her residence?
  • Does G2012 require total-patient-time to be documented?
  • Which private payers are covering telemedicine and virtual care services?
  • Are the provider enrollment requirements different for telehealth services?
  • Can you bill prolonged services (99354, 99355) with an office telehealth service (99202-99215)?
  • When do you use G2012 vs 99441-99443 vs 99421-99423?
  • Is recording and storing telehealth sessions required?
  • What counts as patient initiated for virtual check-in, e-visits, and telehealth?
  • Can “drive by” parking lot swab collections be billed with virtual care codes?
  • How should you refile a denied telemedicine claim when it was initially filed accurately?
  • Are U2001 and U2002 billable for a call that results in ordering a test?
  • Is there a restriction on billing high-level telehealth services (e.g., 99204-99205, 99214-99215)?
  • Can your hospital-based clinic bill telehealth the same way as office based?
  • Are post-op calls billable outside of the surgical package?
  • And many, many more!

IMPORTANT: The types of services that CMS pays for under audio-only telehealth visits expanded again. You can now be reimbursed for behavioral health and patient education services, among other services.

Although payers are not conducting random practice-level audits due to COVID-19, make no mistake, they will be back. Your telemedicine services will most certainly be subject to payer audits once the craziness of the outbreak is over. So, to ensure you get to keep the increased reimbursement these new telehealth coding rules allow, you must comply. It’s not always possible to head off an audit, but it is possible to survive one without having to pay significant financial penalties – if you know how.

As your volume of telehealth and virtual care services increase due to COVID-19, so does the importance of ensuring your claims are files correctly. However, fast-changing coding and billing rules have made this extremely difficult. This upcoming online training will cut through the confusion and provide you with easy-to-implement strategies to get your telehealth and telemedicine claims paid faster and more accurately.

Meet Your Expert

Leonta Williams
RHIA, CCS, CCDS, CPC, CPCO, CRC, CEMC, CHONCDirector of Coding

Leonta (Lee) Williams is currently the Director of Coding at a large physician organization in the southeast.  Lee has over 15 years of experience working in both the outpatient and inpatient setting.  Some of her professional roles have included coder, auditor, practice manager, educator, and trainer.

Lee has presented at national healthcare conferences, private healthcare training organizations, and has frequently contributed articles to healthcare publications.  She currently serves on a number of Boards including Georgia Health Information Management Association (GHIMA) and the American Academy of Professional Coders (AAPC).  Lee has a B.S. in Health Information Management and an MBA with concentration in Healthcare Administration.

Reviews

I thought the webinar was excellent and all of my questions were answered.
Suzanne Pinon
Geriatrician, Dr. Suzanne Pinon, MD