Neurology & Pain Management Coding Alert

Question: Medicare implemented a lot of changes in coverage for telehealth in response to the public health emergency (PHE). Will any or all of these changes carry over into 2021?

Connecticut Subscriber

Answer: Health and Human Services (HHS) Office of Civil Rights renewed the PHE effective October 23, so all the current PHE waivers and regulations will continue until at least January 2021. In all likelihood, HHS will renew the PHE for a good portion of 2021, so you should keep your eyes on the HHS PHE website at www.phe.gov/emergency/news/healthactions/Pages/default.aspx for information about further PHE extensions.

Background: Most of the PHE coding changes affected telehealth. They began in March, when the Centers for Medicare & Medicaid Services (CMS):

• Added numerous services to the telehealth list, including 99217 (Observation care discharge day management …), 99218-99220/99224-99226 (Initial/ Subsequent observation care …), 99324-99337 (Domiciliary or rest home visit …), and 99341-99350 (Home visit for the evaluation and management of a new/established patient …);
• Announced that Medicare would begin paying for telephone services such as 99441-99443 (Telephone evaluation and management service …);
• Lifted geographic and originating site restrictions on telehealth and made the services available to “patients located anywhere in the country, including in a patient’s place of residence”; and
• Changed the definition of “interactive telecommunications system” to include mobile phones.

Additionally, HHS waived HIPPA requirements to allow “everyday communications technologies, such as FaceTime or Skype … during the PHE” for codes on the Medicare Telehealth Code list.

However, whether these changes will become permanent or go back to their pre-PHE states once the PHE ends is unknown. So, you should also take note of the 2021 Medicare Physician Fee Schedule (PFS) final rule to see if any changes will become permanent regardless of the PHE. The final rule is scheduled to be released on or about December 1, 2020.

And you’ll also want to monitor the CMS telehealth list at www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes periodically to see if any services get added or deleted.