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04/09/20

Medicare Advantage and Telehealth Services

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

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04/06/20

UnitedHealth Updates Telehealth Coverage for Therapy Services

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!

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04/06/20

Aetna Expands Telehealth Services to Outpatient Therapy

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!

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04/02/20

Telephone Services: CPT Codes 98966 – 98968

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

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04/01/20

CMS Updates Telehealth and Outpatient Therapy Services

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

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04/01/20

North Carolina Updates on Telehealth

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

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04/01/20

Updates from Indiana, Maryland and Oklahoma

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

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03/28/20

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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