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!

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

Due to the COVID-19 pandemic, many providers of outpatient therapy services are implementing telehealth services to meet the needs of their patients. Since many have never provided telehealth services previously, they are uncertain how to do the billing. In addition, insurance carriers who are expanding telehealth coverage, either voluntarily or state mandated, may not have guidance for providers regarding the billing of outpatient therapy telehealth services. In this article, I will provide answers and/or guidance on some of the questions I have been receiving. QuestionDoes the Medicare program pay for telehealth services provided by a physical therapist, occupational therapist or

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will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded.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

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: