The Centers for Medicare and Medicaid Services (CMS) has announced changes to the submission date for the 2019 Merit-Based Incentive Payment System (MIPS) Performance Period for MIPS eligible clinicians. In addition, CMS has implemented an Extreme and Uncontrollable Circumstances Exception for the 2019 MIPS Performance Period for MIPS eligible clinicians. QuestionWhat is the new deadline to submit data for the 2019 MIPS Performance Period? Answer QuestionWhat happens if I do not submit my individual data by the new deadline date and time? Answer QuestionWhat is the Automatic Extreme and Uncontrollable Circumstances policy? Answer QuestionWho does this automatic exception apply to?

According to the TriWest website, TriWest will pay for telehealth services if you have an active authorization on file to conduct care. The only exception to this rule is Behavioral Health, where virtual visits for the initial appointment are already allowed, VA has provided a waiver for all specialties under PC3 where virtual visits for the initial appointment are now allowed in light of the ongoing pandemic. In addition, TriWest has published I hope you found this article helpful. Thank you for being a Gold Member!

The Michigan Physical Therapy Association (MPTA) has updated their website with information stating “BCBSM has notified MPTA that it will cover CPT Codes 97110, 97112, 97116, 97530 and 97535 via telehealth effective for both commercial and MA population until June 30. The official notification and associated nuances/restrictions will be posted on the Provider Portal soon.”

Effective immediately, all health plans in the state of California shall comply with the following: Health plans shall reimburse providers at the same rate, whether a service isprovided in-person or through telehealth, if the service is the same regardless ofthe modality of delivery, as determined by the provider’s description of theservice on the claim. For example, if a health plan reimburses a mental healthprovider $100 for a 50-minute therapy session conducted in-person, the healthplan shall reimburse the provider $100 for a 50-minute therapy session done viatelehealth. For services provided via telehealth, a health plan may not subject enrollees tocost-sharing greater

Effective March 19, 2020, all outpatient rehabilitative settings shall close and transition to a telehealth platform in accordance with DMS guidance immediately. Click HERE to read it straight from the Governor. Skilled rehabilitation professionals (physical therapists, occupational therapists, speech languagetherapists, and respiratory therapists) shall continue to work in acute care, inpatient rehabilitativesettings, and skilled nursing facilities. Their work will allow patients to heal sooner and return home to their preferred setting. All CDC recommended protective measures shall be in place when providing services to patients. Home health rehabilitation professionals shall use best clinical judgment to determine best practicefor the implementation

QuestionDoes UnitedHealthcare (UHC) pay for telehealth for outpatient physical, occupational and/or speech therapy services? Answer QuestionDoes UnitedHealthcare (UHC) pay for E-Visits under outpatient physical, occupational and/or speech therapy services? Answer QuestionCan I charge UnitedHealthcare (UHC) patients cash for telehealth services if not covered by their plan? Answer I hope you found this article helpful! Thank you for being a Gold Member!

QuestionDoes TRICARE pay for telehealth services for outpatient physical, occupational and/or speech therapy services? Answer QuestionWhat CPT code(s) do I use to bill for telehealth for TRICARE beneficiaries? AnswerThe TRICARE Policy Manual is not clear on what code(s) to use for telehealth services. Your first option is to contact TRICARE. Per the TRICARE Policy Manual, April 2015, Change 60 (March 13, 2020), Chapter 7, Medicine, Section 2.3.2.3, it states the following: “When billing for synchronous telemedicine services, providers will use CPT or HCPCS codes with a GT modifier for distant site and Q3014 for originating site to distinguish telemedicine services. In addition,

In a memorandum dated March 17, 2020, the state of Louisiana, Louisiana Department of Health, Bureau of Health Services Financing, announced “Effective for dates of service on or after March 17, 2020, and for the duration of the COVID-19 emergency, Louisiana Medicaid encourages and will reimburse the use of telehealth, when appropriate, for rendering physical therapy, occupational therapy, and speech therapy to members. Telehealth can facilitate the continuation or establishment of these services while complying with the need for social distancing”. To read the entire memorandum, click This is a tremendous opportunity for therapists in the state of Louisiana and