G codes revealed for certain services. Coders want to stay current on all the coding changes each year, especially when it comes to something as important as the Medicare Physician Fee Schedule (MPFS) Final Rule; this year, CMS turned its attention to encouraging the use of technology, when applicable, for some services. “We are interested in recognizing changes in healthcare practice that incorporate innovation and technology in managing patient care,” CMS said during a webinar on the 2019 MPFS Final Rule. “We are aiming to increase access for Medicare beneficiaries to these services that are routinely furnished via communication technology by clearly recognizing a set of services that are defined by and inherently involve the use of communication technology.” Result: CMS revealed some proposals designed to help coders report — and get paid for — telehealth and some other “virtual care” services. Check out what our experts had to say about these topics, and how they’ll impact your coding in 2019. Use This Code for Prolonged Services Telehealth CMS has approved a pair of telehealth G codes for use in 2019, according to the Final Rule. These codes are: Impact: “These two codes will allow providers to get additional reimbursement for the extremely long visits with patient who are distraught or who have many question or complex situations,” explains Marcella Bucknam, CPC, CCS-P, COC, CCS, CPC-P, CPC-I, CCC, COBGC, revenue cycle analyst with Klickitat Valley Health in Goldendale, Washington. “For coders I think that the main effect is that they will have to be aware of the rules for billing prolonged services and make sure their providers document the prolonged times when appropriate. Otherwise, these codes won’t have other special billing rules beyond the normal telehealth modifiers and other requirements,” continues Bucknam. So how will G0513 and G0514 work? According to Kent Moore, senior strategist for physician payment at the American Academy of Family Physicians, “if the physician provides a Medicare-covered preventive service via telehealth that runs long as defined by Medicare, the coder can add these codes to the claim to capture the extra physician time spent on the service. The rules for using the codes is the same as when the service is provided in-person, so you can recycle whatever you wrote about them originally,” Moore continues. Remember: The HCPCS G codes are for use with Medicare payers only; private payers do not recognize them. CMS Doing Real Work on Virtual Care Policies The Final Rule also included an important bit about how it will compensate practices for virtual care. Back in July, CMS proposed two HCPCS codes — GVCI1 and GRAS1 — for virtual check-ins and remote evaluation of patient videos and images. According to the agency, these proposals were “placeholders” for the end codes, which will be paid separately and use “communication technology” for physicians’ services. To that end, CMS approved the following HCPCS codes: Effect: “This is good news as more and more services are being provided electronically, which has really not been paid much by Medicare. Most practices will need to develop new methods for charge capture and documenting that these electronic encounters,” Bucknam says. “Probably most practices have been doing some of this for free already, so it will require a change in thinking and processes to make sure the services are billed rather than simply provided for free.” To Bucknam’s point about the importance of education for coders reporting virtual services, Moore lists the elements that will need to be present for Medicare to cover a virtual-check-in: