On April 15, 2021, Xavier Becerra, Secretary of Health and Human Services, renewed the Public Health Emergency (PHE) due to COVID-19. The PHE will now end at the end of the day on July 19, 2021. Due to this extension, the Centers for Medicare and Medicaid Services (CMS) will continue to reimburse for outpatient physical, occupational and speech therapy services delivered via telehealth until at least until the end of the day on July 19, 2021.

The Centers for Medicare and Medicaid Services (CMS) has updated the list of outpatient physical, occupational and speech therapy services that can be delivered via telehealth during the COVID public health emergency (PHE). The additional CPT codes added are as follows: 92526 92607 92608 92609 92610 92626 92627 96105 96125 97129 97130 To view the entire list of CPT codes that can be delivered via telehealth and reimbursed by CMS, click HERE. Remember that once the PHE is declared over, physical therapists, occupational therapists and speech-language pathologists will no longer be able to be reimbursed by the Medicare program for

Priority Health Michigan has updated their telemedicine medical policy. This policy contains important information regarding the delivery of outpatient physical, occupational and speech therapy services via telehealth. To access the updated policy, click Thank you for being a Gold Member!

Humana has released a revised telehealth policy for their commercial plans due to the COVID-19 public health emergency. In addition, Humana Medicare Advantage plans are applying the same coverage-related waivers to Original Medicare telehealth services that the Centers for Medicare & Medicaid Services (CMS) has announced in response to the COVID-19 PHE. To read this detailed revised telehealth policy, log into your Gold Member account and click I hope you found this article and Humana’s telehealth policy to be informative and helpful. Thank you for being a Gold Member!

Aetna has announced they have extended their coverage of telehealth services for physical, occupational and speech therapy for their Commercial and Medicare Advantage plans. The extended coverage end date is I hope you found this information helpful. Thank you for being a Gold Member!

On January 1, 2021, outpatient physical, occupational and speech therapy services provided via telehealth for UnitedHealthcare (UHC) commercial plans will be changing and there will be a difference in telehealth coverage between providers who submit claims on a 1500-claim form and providers who submit claims on a UB-04 claim form. QuestionWhat is changing on January 1, 2021 for UHC Commercial plans? Answer QuestionWhat place of service (POS) code is to be used on the claim form for an outpatient therapy visit conducted via telehealth? Answer QuestionWhat is changing on January 1, 2021 for UHC Medicare Advantage plans? Answer

On January 1, 2021, outpatient therapy services provided via telehealth for Cigna beneficiaries will be changing and there will be a difference in telehealth coverage between providers who submit claims on a 1500-claim form and providers who submit claims on a UB-04 claim form once the public health emergency is declared over. To read about the changes concerning Cigna and outpatient therapy services provided via telehealth, click HERE. I hope you found this article helpful. Thank you for being a Gold Member!

The Centers for Medicare and Medicaid Services has issued their summary of the policies in the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount. In addition, I published an article on December 2, 2020 titled “CMS Releases 2021 Final Rule for Services Reimbursed Under the MPFS where I provided a summary of the following topics in the CY 2021 Final Rule: 2021 Medicare Conversion Factor and 9% Payment Reduction Accessing the 2021 Relative Value Units (RVU’s) for Each CPT Code 2021 Annual Therapy Threshold Dollar Amount Student