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03/19/20

Does UnitedHealthcare Pay for Telehealth for Outpatient Therapy?

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!

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03/19/20

Does TRICARE Pay for Telehealth for Outpatient Therapy?

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,

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03/17/20

Louisiana Medicaid to Cover Telehealth for Therapy Services

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

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03/16/20

TRICARE Releases Final Rule Regarding Assistants

TRICARE has finally issued the long awaited final rule to add physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) as TRICARE authorized providers to provide physical therapy or occupational therapy services under the supervision of a TRICARE-authorized physical therapist (PT) or occupational therapist (OT) in accordance with Medicare’s rules for supervision and qualification. TRICARE will implement I hope you enjoyed this article and this great news that has long been overdo. Thank you for being a Gold Member!

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03/13/20

COVID-19 and Telehealth Services

Due to the coronavirus (COVID-19), I am receiving many questions regarding telehealth and the ability for physical therapists, occupational therapists and speech-language pathologists to provide telehealth services and to have those services reimbursed by the Medicare program and private/commercial insurance carriers. See below for some of the common questions I receive and the answers as of March 13, 2020. QuestionWith the Centers of Medicare and Medicaid Services changing the rules and regulations for telehealth services due to the coronavirus (COVID-19), does this now mean physical therapists, occupational therapists and speech-language pathologists can now provide telehealth services to Medicare beneficiaries, bill

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03/09/20

UnitedHealthcare Community Plan Updates Several Therapy Policies

UnitedHealthcare Community plan has revised one clinical policy pertaining to cognitive rehabilitation, 3 coverage determination guidelines pertaining to outpatient physical, occupational and speech therapy services and 2 utilization review guidelines pertaining to outpatient physical, occupational and speech therapy services. The following policies have been revised with an effective date of April 1, 2020 except for Cognitive Rehabilitation which became effective March 1, 2020: I hope you found this article informative and will assist you treating and billing UnitedHealthcare Community Plan beneficiaries for dates of service on and after April 1, 2020. Thank you for being a Gold Member!

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03/09/20

UnitedHealthcare Oxford Updates Several Therapy Policies

UnitedHealthcare Oxford has revised several of their clinical policies pertaining to outpatient physical, occupational and/or speech therapy services. The following policies have been revised with an effective date of April 1, 2020: I hope you found this article informative and will assist you treating and billing UnitedHealthcare Oxford beneficiaries for dates of service on and after April 1, 2020. Thank you for being a Gold Member!

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03/09/20

UHC Updates Habilitative Services and Outpatient Rehabilitation Therapy Coverage Determination Guideline

UnitedHealthcare Commercial has updated their coverage determination guideline pertaining to Habilitative Services and Outpatient Rehabilitation Therapy with an effective date of April 1, 2020. In this updated coverage determination guideline, UHC lists certain CPT codes that are only payable as habilitative therapy services when they are billed with one of the habilitative diagnosis codes in the primary position on the claim. In addition, in this coverage determination guideline, UHC lists which ICD-10 diagnosis codes, when listed in the primary position on the claim form, qualify as habilitative therapy services only. In addition, UHC provides which CPT codes are payable for

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