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Will Commercial Insurance Carriers Reimburse for Telehealth After the PHE Ends?

On May 4, 2023, I published an article “Will CMS Pay for Telehealth After May 11, 2023?“. I have now been receiving questions asking if commercial insurance carriers and Medicare Advantage plans will reimburse for outpatient physical, occupational and speech therapy services delivered via telehealth after the public health emergency (PHE) ends at the end of the day on May 11, 2023. In this article, I will answer that question plus provide links to Cigna, UnitedHealthcare and Humana’s telehealth policies. The answer is

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UHC Commercial Reimbursement Policy Update

UnitedHealthcare (UHC) has announced a commercial reimbursement policy update for outpatient physical, occupational and speech therapy services provided in facility settings. This would include any setting that submits claims to UHC on a UB-04 claim form. This policy update will impact UHC Commercial Plans as well as UHC Oxford Health Plans. The new Outpatient Rehabilitation Therapy Services Policy, Facility will be effective for dates of service on and after I hope you found this information helpful. Thank you for being a Gold Member!

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New York Mandates Insurances Pay for Telehealth Services

On March 3, 2020, New York State Department of Financial Services issued Insurance Circular Letter No. 3 (2020) to All Insurers Authorized to Write Accident and Health Insurance in New York State, Article 43 Corporations, Health Maintenance Organizations, Student Health Plans Certified Pursuant to Insurance Law § 1124, and Municipal Cooperative Health Benefit Plans. The letter goes on to state the following: “Issuers are reminded that Insurance Law §§ 3217-h and 4306-g and Public Health Law § 4406-g prohibit issuers from excluding a service that is otherwise covered under a comprehensive health insurance policy or contract because the service is

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Double Booking Non-Medicare Patients: How Do I Bill?

Two weeks, I wrote an article titled “Can I Double Book Medicare Patients“. If you have not had a chance to read this article, I would suggest you take a few minutes to read it as it will really help you in your practice and organization understand the rules and regulations regarding scheduling and billing of double booking Medicare patients. This article then led to other questions that I will address in this article. The last question will show you how it’s possible to bill 7 time-based units plus 2 untimed CPT codes within a one hour time period. QuestionCan

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