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Effective April 9, 2020, this article is no longer current.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

This afternoon, March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security (CARES) Act into law. The CARES Act has several important provisions related to therapy services. A few of them are as follows: Sec. 3703. Expanding Medicare Telehealth Flexibilities This section will broaden the authority of the Secretary of Health and Human Services to waive the telehealth requirements of section 1834(m) of the Social Security Act during the COVID-19 emergency period. This would enable Medicare beneficiaries to access telehealth, including in their home, from a broader range of providers, reducing COVID-19 exposure. To make it clear,

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.

On March 26, 2020, MedRisk emailed providers notifying them that they are putting provisions in place to consider providers who have telerehabilitation programs to utilize these services for MedRisk/SPNet referrals during this time of social distancing and isolation. MedRisk states to continue to bill MedRisk/SPNet directly for your services using standard billing codes and ensure the Place of Service is 02 when administering telerehabilitation. Click HERE to access the document MedRisk sent via fax to its providers.