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Outpatient Therapy In an Assisted Living Facility

I receive many questions regarding treating Medicare beneficiaries for outpatient physical, occupational and/or speech therapy who reside in an assisted living facility (ALF). In this article, I will answer the following questions:

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New Place of Service Code 27

In this article, I will provide answers to the following questions regarding the new place of service (POS) code 27.

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New and Revised Place of Service Codes for Telehealth

Effective January 1, 2022, there will be a new additional Place of Service (POS) code for telehealth and the current descriptor for the current POS code for telehealth has been changed. QuestionWhat is the new POS code for telehealth? Answer QuestionWhat is the descriptor for the new telehealth POS code? Answer QuestionWill CMS reimburse for telehealth services when billed using the new POS code? Answer QuestionWhat is the current POS code for telehealth and what is the revised descriptor for this POS code? Answer QuestionDuring the time that the Medicare program is paying for outpatient therapy delivered via telehealth due

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TRICARE Place of Service Update for Telemedicine Claims

Health Net Federal Services, LLC (HNFS), who is the TRICARE West Region Contractor, has provided an update on what place of service (POS) code to use on the 1500-claim form when providing a telehealth visit. HNFS is now asking providers to use the POS that represents In addition, HNFS has provided an update on reimbursement and resubmission of claims. By using an incorrect POS code, the provider may have been or will be reimbursed at the facility CHAMPUS Maximum Allowable Charge (CMAC) rate, rather than a non-facility CMAC. If you provided telemedicine services from a non-facility setting, you may submit

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Cigna to Cover Virtual Care for PT, OT and SLP

Effective April 9, 2020, this article is no longer current.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

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UnitedHealthcare Adds Telehealth Coverage to Therapy Services

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

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