Telehealth
The telemedicine will be providing to improve a patient's health by permitting two-way, real time interactive audio and video communication between into the patients, and the physician or practitioner at the distant site.
Requirements
- Two way real time interactive audio and video communication must be documented in the medical record.
- Type of communication -Used devices.
- Patient Location and Provider Location.
Place of Services (POS) Changes
- Effective Date - January 1, 2022
- Implementation Date - April 4, 2022
The place of service can be used to specify the setting information necessary to pay the claims correctly. And new place of service introduced place of service (POS 10), revised the description of POS code 02 to meet the overall industry needs.
POS 02 - Telehealth Provided Other than in "Patient’s Home"
Description: The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.
POS 10: Telehealth Provided in "Patient’s Home"
Description: The location where health services and health related services are provided or received through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
Insurance Updates
Beginning Jan. 1, Anthem and UnitedHealthcare (UHC) will require commercial and Medicare Advantage plans to use new place of service (POS) 10 for telehealth provided in the patient’s home.
Place of service 02 should continue to be used when telehealth is provided anywhere other than a patient’s home (e.g., a hospital or skilled nursing facility).
Mental Health Services
Reimbursement for audio-only services for mental health will continue after the public health emergency ends.
Following changes made through new federal legislation, CMS will allow audio-only services to be provided for the diagnosis, evaluation, and treatment of mental health conditions and substance use disorders after the public health emergency (PHE) ends.
Telehealth Extended Date
UnitedHealthcare will extend the expansion of telehealth access for in-network and out-of-network providers through the national public health emergency period, currently scheduled to end April 15, 2022.
The Centers for Medicare & Medicaid Services (CMS) proposed in the 2022 Physician Fee Schedule to extend telehealth flexibilities through 2023 instead of through the end of the COVID-19 public health emergency, which is expected to run through this year.
APA supported CMS proposal allowing all psychological and neuropsychological testing services to be provided via telehealth after the PHE ends.
The CMS adopted this proposal, keeping psychological and neuropsychological testing on the temporary (category 3) telehealth list through the end of 2023.
Info: Medicare does not identified a need for new place of service code 10. And the MACs will instruct their providers to continue to use the Medicare billing instructions for Telehealth claims.
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