CMS

Telemedicine and telehealth services have evolved into an innovative option for healthcare. But can providers expect to receive robust reimbursements from insurance and Medicare similar to in-person services?

The Centers for Medicare and Medicaid Services (CMS) offered guidance to broaden access to telemedicine and telehealth in the Proposed Physician Fee Schedule published in August 2020. These new rules allow doctors and practitioners to meet the direct supervision requirement of “incident-to-billing” through remote supervision.

Now you can use these rules to achieve your practice growth goals. CarePICS simplifies the telehealth workflow for your practice and tracks those activities. Read below for resources to support the successful adoption of telehealth, including policy changes and advice for how to code and bill for remote management of patients.

CMS Healthcare Policy Changes

Both commercial payors and CMS have dragged their heels in the past over formal policy decisions on telemedicine. Consequently, many healthcare providers have been hesitant to invest the time, money and resources into telehealth due to concerns over reimbursement.

The COVID-19 public health emergency (PHE), however, has cleared up misconceptions and prioritized urgent shifts in access to healthcare. Many states require commercial payors to reimburse for telemedicine while payors in states without reimbursement laws often cover telemedicine anyway. After a year of wearing masks and social distancing, “almost three-quarters of Americans surveyed said the pandemic has made them more eager to try virtual care,” says Harvard Health Publishing.

COVID-19 has revealed the potential of telehealth. According to the American College of Cardiology, “The rule finalizes policy changes to maintain certain elements of the various telehealth flexibilities authorized on a temporary basis during the COVID-19 PHE, with some proposals made permanently.” The CMS policy ensures that physicians can deliver expedient healthcare, second opinions from diverse voices and a full continuum of care for patients all across the country.

What Codes to Use for Telehealth Reimbursement

Telehealth appointments and virtual consultations come in many forms — telephone, video chat, text messaging, email, patient portals. CarePICS can keep you connected with your peripheral artery disease, critical limb ischemia and wound care patients and provide the best possible care.

Use these telehealth and virtual health procedure codes as you work with patients and other providers, using secure CarePICS technology. (Values are CMS par values.)

• G0406-G0408: Follow-up inpatient consults, $39.85-$105.38, 13-35 minutes
• G0425-G0427: Telehealth consults, ER, inpatient, $102.13-$205.50, 30-70 minutes
• G2010: Patient report for established patient, $12.12, patient shares captured video or images
• G2012: Remote check-in for established patient, $14.81, provider call to check patient
• 99201-99205: New patient office visit, $45.79-$210.45, 10-60 minutes
• 99211-99215: Established patient office visit, $22.70-$146.87, 5-40 minutes
• 99451: Virtual consult given, $37.10, 5 minutes
• 99452: Virtual consult requested, $37.10, 5 minutes
• 99446-99449: Virtual consult given over 5 minutes, $18.58-$74.50, 10-31+ minutes

For more information

2021 will be a year of flux for the healthcare industry. CarePICS’ team of community-minded experts are committed to providing a curated and reliable list of telehealth and virtual health procedure codes. Visit our website to see how we’re creating a smart way to manage patients with wounds and vascular disease while generating new revenue opportunities for medical practices.

About CarePICS

CarePICS^® is a HIPAA-compliant telehealth platform designed to manage vascular disease and wound care patients. CarePICS enables virtual consults, telehealth visits, clinical image reporting, and automated medical supply ordering.