Today, I am receiving emails and phone calls from providers around the country that believe the Medicare program covers telehealth services provided by a physical therapist, occupational therapist or a speech-language pathologist. I have even received emails from several providers stating they provided telehealth visits to Medicare beneficiaries, submitted the claim to their Medicare Administrative Contractor using place of service code 02 on the 1500-claim form and appended modifier 95 or modifier 95 and the GP modifier to the CPT code(s) on the claim form and were paid. I hate to tell you, but you were paid in error. As

On April 16, 2020, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal year (FY) 2021 proposed rule for facilities under the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). Highlights of the proposed rule include the following: In the FY 2021 IRF PPS proposed rule, CMS is proposing to allow non-physician practitioners to perform any of the IRF coverage service and documentation duties that are currently required to be performed by a rehabilitation physician, provided that the duties are within the non-physician practitioner’s scope of practice under applicable state law CMS is proposing to no longer require

On April 10, 2020, the Centers for Medicare and Medicaid Services (CMS) released the FY 2021 Skilled Nursing Facility (SNF) proposed rule. To access the Fact Sheet on this proposed rule, click HERE. To access the proposed rule on the Federal Register, click HERE.

During a Centers for Medicare and Medicaid Services (CMS) “Office Hours” call on April 14, 2020, a participant asked if E-Visits (G2061, G2062 and G2063) and Virtual Check-Ins (G2010 and G2012) could be billed on a UB-04 claim form? In addition, a question was asked if you can bill HCPCS Level II codes for more than 1 7-day period? In this article, I will answer both questions. The answer from the CMS representative was I hope you found this article helpful. Thank you for being a Gold Member!

During a Centers for Medicare and Medicaid Services (CMS) “Office Hours” call on April 14, 2020, I had the opportunity to ask CMS if a physical therapist or occupational therapist employed by a physician practice can provide a telehealth visit and have that telehealth visit billed incident-to the physician (under the physicians NPI in Box 24J on the 1500-claim form)? The answer from the CMS representative was I hope you found this article and the answer to the question helpful. Thank you for being a Gold Member!

The Michigan Physical Therapy Association (MPTA) has a dedicated webpage to COVID-19 on the MPTA News page. Once on the page, you will see + MPTA Covid-19 Consolidated Resources and Updates. Click the + sign. Scroll down and you will see the latest information on telehealth coverage by some of the major insurance carriers in the State of Michigan.

Effective with dates of service beginning on April 13, 2020, the Texas Division of Workers’ Compensation as issued an emergency rule regarding rehabilitation services and telehealth services. This emergencyrule allows health care providers licensed to perform physical medicine and rehabilitation services, including physical therapists, occupational therapists, and speech pathologists to bill and be reimbursed for services currently allowed under CMS telemedicine and telehealth billing codes. Health care providers must bill for telemedicine or telehealth services using the same billing, coding, reporting, and documentation requirements used for in-person services and include a place of service code “02 – telehealth” on the

On April 13, 2020, Arkansas Blue Cross Blue Shield (BCBS) announced they have expanded telehealth services to include outpatient physical, occupational and speech therapy services. The temporary changes are retroactive to April 1 and will be in effect through at least May 15, 2020, and could beextended after that, if circumstances warrant. There will be no waiver of cost share (e.g. copays, deductibles, and coinsurance) for these services and all contractual limitations, conditions, policies, and procedures will apply. Codes must be submitted with place of service 02 and modifier 95 or GT to indicate billing of a telehealth service. Appropriate