Effective with dates of service beginning on April 13, 2020, the Texas Division of Workers’ Compensation as issued an emergency rule regarding rehabilitation services and telehealth services. This emergencyrule allows health care providers licensed to perform physical medicine and rehabilitation services, including physical therapists, occupational therapists, and speech pathologists to bill and be reimbursed for services currently allowed under CMS telemedicine and telehealth billing codes. Health care providers must bill for telemedicine or telehealth services using the same billing, coding, reporting, and documentation requirements used for in-person services and include a place of service code “02 – telehealth” on the

On April 13, 2020, Arkansas Blue Cross Blue Shield (BCBS) announced they have expanded telehealth services to include outpatient physical, occupational and speech therapy services. The temporary changes are retroactive to April 1 and will be in effect through at least May 15, 2020, and could beextended after that, if circumstances warrant. There will be no waiver of cost share (e.g. copays, deductibles, and coinsurance) for these services and all contractual limitations, conditions, policies, and procedures will apply. Codes must be submitted with place of service 02 and modifier 95 or GT to indicate billing of a telehealth service. Appropriate

QuestionAs of April 15, 2020 at 5:00pm EDT, does the Medicare program pay for telehealth services provided by a physical therapist, occupational therapist or speech-language pathologist? Answer I hope you found the answer to this question to be a definitive answer. Thank you for being a Gold Member!

On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule titled “Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency“. In this interim final rule, CMS did add CPT codes that are typically billed by physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) as covered telehealth services; however, they did not add PTs, OTs and SLPs as telehealth providers. This led many to ask why would CMS add these CPT codes to the list of covered therapy services if they did not add PTs,

While we wait for the Centers for Medicare and Medicaid Services (CMS) to add physical therapists, occupational therapists, and speech-language pathologists as telehealth providers for outpatient therapy services, a question I am receiving is how does this relate to Medicare Advantage plans. What you need to remember is that traditional Medicare and Medicare Advantages plans are not the same. Regarding Medicare Advantage plans and do they pay for telehealth services for outpatient physical, occupational and speech therapy services is Medicare Advantage plan specific. You must contact each insurance carrier to see if they have expanded telehealth services to include outpatient

On April 5, 2020 at 11:50pm CDT, UnitedHealthcare (UHC) posted an updated about telehealth services for physical, occupational and speech therapy services. If you submit claims on either a 1500-claim form or a UB-04 claim form, this is a must read article. The new update now states the following: Reimbursable codes are limited to the specific set of physical, occupational and speech therapy codes listed I hope you found this article helpful, especially if you are not a private practice. Thank you for being a Gold Member!

Last week, Aetna announced they were expanding telehealth services to outpatient therapy services until June 4, 2020. That’s the good news! Now for the not-so-good news. Try finding this announcement anywhere on the Aetna website. Lucky for you as a Gold Member, I will give you the step-by-step instructions how to access this announcement from Aetna and get the reference that you need. As an Aetna provider, you must I hope you found this article helpful. Thank you for being a Gold Member!

On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment period discussing CPT codes 98966, 98967 and 98968. The description of each of these CPT codes per the American Medical Association CPT 2020 Professional Edition, page 747 are as follows: 98966: Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours