On May 13, 2020, American Specialty Health Group, Inc. (ASH Group) released updated guidance on the billing of telehealth services to current Cigna Customers. ASH Group states to use this revised Notice as a guide on how to bill for telehealth services during via this interim process. This interim process will be effective for dates of services retroactive to March 2, 2020 going forward through at least May 31, 2020. To access this revised guide, click In addition, check out my FAQs on Cigna and telehealth that I published on April 23, 2020. I hope you find this updated guidance

This article was updated on May 21, 2020. See below for updated answers. On April 30, 2020, the Centers for Medicare and Medicaid Services (CMS) temporarily expanded who can provide and be paid for telehealth services under the Medicare Part B program to now include physical therapists, occupational therapists and speech-language pathologists. It was clear that this expansion of telehealth services included therapist-owned and physician-owned private practices but were unclear if this also included hospital outpatient therapy departments. Well, as of May 5, 2020, we now know the answer. QuestionCan a hospital outpatient therapy department be paid for a telehealth

Effective with dates of service on and after April 16, 2020, TRICARE recognizes physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) as TRICARE-Authorized Providers. On April 22, 2020, TRICARE updated their Policy Manual to include PTAs and OTAs. Highlights of the Policy Manual update include the following: Scope of practice of a PTA and OTA Supervision requirements of the PTA and OTA based on practice setting Reimbursement for services provided by a PTA or OTA Application of the CQ and CO modifier when services are provided in whole or in part by a PTA or OTA, respectively Payment differential

Due to the COVID-19 Pandemic, UnitedHealthcare (UHC) has expanded telehealth services to include outpatient physical, occupational and speech therapy services. In this article, I will answer some of the more common questions I have received regarding UnitedHealthcare’s expansion of telehealth services to include physical, occupational and speech therapy services. QuestionWhen did UHC expand telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat is the end date of the expansion of telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat plans does the telehealth expansion apply to? Answer QuestionWhat CPT codes will UHC pay for

Due to the COVID-19 Pandemic, Cigna has expanded telehealth services to include outpatient physical, occupational and speech therapy services. In this article, I will answer some of the more common questions I have received regarding Cigna’s expansion of telehealth services to include physical, occupational and speech therapy services. QuestionWhen did Cigna expand telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat is the end date of the expansion of telehealth services to outpatient physical, occupational and speech therapy services? Answer (Updated May 24, 2020) QuestionWhat plans does the telehealth expansion apply to? Answer QuestionWhat CPT codes will

Due to the COVID-19 Pandemic, Aetna has expanded telehealth services to include outpatient physical, occupational and speech therapy services. In this article, I will answer some of the more common questions I have received regarding Aetna’s expansion of telehealth services to include physical, occupational and speech therapy services. QuestionWhen did Aetna expand telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat is the end date of the expansion of telehealth services to outpatient physical, occupational and speech therapy services? Answer (Updated June 1, 2020) QuestionWhat plans does the telehealth expansion apply to? Answer QuestionWhat CPT codes will

National Correct Coding Initiative (NCCI) edits are updated quarterly by the Centers for Medicare and Medicaid Services (CMS) and Capital Bridge, CMS’ NCCI coding contractor. Updates occur on January 1, April 1, July 1, and October 1 of each calendar year. Typically, the January 1 update sees the most additions, deletions and revisions due to new, revised and deleted CPT codes taking effect on January 1 of the calendar year. Due to the COVID-19 Public Health Emergency as well as CMS’s expansion of telehealth services, CMS updated procedure-to-procedure (PTP) edits and Medically Unlikely Edits (MUEs) for Current Procedural Terminology (CPT)

Due to the coronavirus (COVID-19), I am receiving many questions regarding the ability for physical therapists, occupational therapists and speech-language pathologists to provide outpatient therapy services in a patient’s home 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 to each question. This article was originally published on March 16, 2020, but I republished it today and added additional Q&As. QuestionDoes the Medicare program reimburse for outpatient therapy in a patient’s home? Answer QuestionWhat is considered a patient’s home? Answer QuestionWith the