Telehealth is witnessed high and low acceptance during COVID-19 pandemic last year, and it might play a key role in care delivery in 2022. During pandemic, guidelines has been loosened for more acceptance of telehealth services as in-person care may not be available all the time. CMS has updated the Telehealth medical billing Services List to show minor changes due to various activities, such as the CY 2022 MPFS Final Rule and legislative changes from the Consolidated Appropriations Act of 2021. In this article, we briefly discussed these Medicare telehealth billing guidelines.
Temporarily Added Telehealth Services
Due to the provisions of the Consolidated Appropriations Act of 2021, the CMS continues to evaluate the inclusion of telehealth services that were temporarily added to the Medicare telehealth services list during the COVID-19 PHE (Public Health Emergency). CMS has finalized certain services added to the Medicare telehealth services list will remain on the list through December 31, 2023.This will allow additional time for CMS to evaluate whether each service should be permanently added to the Medicare telehealth services list. The previous telehealth restrictions limiting Telehealth Mental Health services to only patients residing in rural areas, no longer apply. CMS also extended inclusion of certain cardiac and intensive cardiac rehabilitation codes through the end of CY 2023. This will allow for more time for CMS to gather data to decide whether or not each telehealth service will be permanently added to the Medicare telehealth services list.
Definition of ‘Originating Sites’
Section 123 of the Consolidated Appropriations Act (CAA) also removed the geographic restrictions and added the home of the beneficiary as a permissible originating site for telehealth services furnished for the purposes of diagnosis, evaluation or treatment of a mental health disorder. In CR 12519, CMS clarified that the patient’s home includes temporary lodging such as hotels, or homeless shelters, or other temporary lodging that are a short distance from the patient’s actual home, where the ‘originating site facility fee’ doesn’t apply.
Revised POS 02 and POS 10
POS 02 (Telehealth provided other than in patient’s home): The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.
POS 10 (Telehealth provided in patient’s home): The location where health services and health related services are provided or received through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
Newly Added Modifiers
The 2 additional modifiers for CY 2022 relate to telehealth mental health services. The modifiers are:
- FQ – A telehealth service was furnished using real-time audio-only communication technology
- FR – A supervising practitioner was present through a real-time two-way, audio/video communication technology
- 93 – A new modifier 93 (Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system) became effective January 1, 2022. This modifier which allows reporting of medical services that are provided via real-time interaction between the physician or other qualified health care professional and a patient through audio-only technology.
For Telehealth services, every payer has unique billing guidelines and reimbursement policies, we can assist you in getting accurate reimbursements for your practice. Medisys Data Solutions is a leading medical billing company providing specialty-wise billing and coding services. To know more about our Telehealth billing services, contact us at email@example.com/ 302-261-9187