Hospitals, E-Visits and the UB-04 Claim Form

The Centers for Medicare and Medicaid Services (CMS), due to the Public Health Emergency (PHE) due to COVID-19 Pandemic, are allowing physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) to provide the following services:

G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment

G2012: Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion

G2061: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes

G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes

G2063: •Qualified non-physician healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes

CMS has made it clear that the above services can be billed by PTs, OTs and SLPs who practice in a private practice and submit claims on a 1500 claim form. What is unclear is can the above services be provided by PTs, OTs and SLPs who practice in a rehabilitation agency, skilled nursing facility, home health agency doing Part B in the home and outpatient hospital therapy departments (including critical access hospitals) and submit claims on a UB-04 claim to their Medicare Administrative Contractor (MAC) and have these services paid by their MAC.

On March 30, 2020, CMS

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