On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment period titled “Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency“. This interim final rule with comment period contains important information for not only outpatient physical, occupational and speech-language pathology therapy services, but also therapy provided under a Home Health Agency plan of care and inpatient rehabilitation facilities. Lets start with outpatient physical, occupational and speech therapy services and find out what’s new! QuestionDid CMS add physical therapists (PTs), occupational therapists (OTs) and speech-language

Here are 2 updates regarding telehealth services being expanded to outpatient therapy services. Effective March 30, 2020, NC Medicaid is temporarily modifying its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid and NC Health Choice beneficiaries. These temporary changes will be retroactive to March 10, 2020, and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded. Click HERE to read the special bulletin and its application to outpatient physical, occupational and speech therapy services. Blue Cross Blue Shield (BCBS) of North Carolina

Please click on the applicable links below regarding updates on telehealth coverage for outpatient therapy services in the states of Indiana, Maryland and Oklahoma. Executive Order from Governor of Indiana Executive Order from Governor of Maryland Oklahoma Board of Medical Licensure and Supervision

Effective April 9, 2020, this article is no longer current. Click HERE to read the latest about Cigna and their coverage of outpatient physical, occupational and speech therapy delivered via telehealth. This article was updated on March 28, 2020 by adding a link to American Specialty Health and updating the place of service code to use on the 1500-claim form. In addition, it’s my interpretation that Cigna is only paying for telehealth services for physical, occupational and speech therapy submitted on a 1500-claim form by a private practice. Institutional providers (i.e. rehab agencies and hospital outpatient departments) should contact Cigna

With many states mandating insurance plans in their state expand telehealth services and reimbursement to include physical therapy (PT), occupational therapy (OT) and speech therapy (ST) as well as several insurances expanding telehealth services and reimbursement on their own, I am being asked what CPT code(s) do I use to bill for telehealth services for physical, occupational and/or speech therapy services. The answer is the one that you do not like. It is insurance carrier specific and you have to check with each insurance carrier and yes, this includes workers compensation. Codes that I am commonly seeing insurance companies mention

On March 26, 2020, at 11:00pm CDT, Unitedhealthcare (UHC) posted the following announcement on their website:

On March 26, 2020, the Ohio Bureau of Workers’ Compensation announced they will temporarily expand the providers permitted to bill for virtual check in services and telephone services to check in with established patients. Telephone services include CPT codes 99371, 99372 or 99373. The virtual check in service codes include CPT codes 98970, 98971, and 98972. The virtual check-incontact is usually made electronically through a patient portal. For purposes of this temporary policy update, the contact can also be made by email. These code sets are currently billed by providers who can render Evaluation and Management Services. Under Policy Alert

One Call sent providers a 2-page “Network Frequently Asked Questions” document via fax. In this fax, One Call states they will now cover telerehabilitation for their injured clients. One Call provides answers to 10 frequently asked questions. If submitting claims on a 1500-claim form, One Call states to use 02 as the place of service code. You will bill for telerehabilitation the same as you for outpatient therapy utilizing standard CPT coding and state guidelines. Click HERE to access the 2-page One Call document.