Medicare Telehealth Visits:
Effective for services starting March 6, 2020, and for the duration of the COVID-19 Public Health Emergency (PHE), Medicare will make payments for Medicare telehealth services furnished to patients in broadened circumstances.
During the PHE, clinicians can use popular applications that allow for video chat such as Apple FaceTime and Skype, thanks in part to enforcement discretion by the HHS Office of Civil Rights. Clinicians who seek additional privacy protections for telehealth while using video communication products should provide such services through technology vendors that offer HIPAA business associate agreements (BAAs) with their video communication products.
In addition, clinicians may utilize telephone without video for other communication technology-based services.
•Patients may be either a new or established patient.
•These visits are the same services as would be provided during in-person visit and are paid at the same rate as in-person visits.
•The patient may be located in any geographic location (not just those designated as rural), in any healthcare facility, or in their home.
•The Medicare coinsurance and deductible would generally apply to these services; however, the HHS Office of the Inspector General is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
Common telehealth CPT and HCPCS codes include:
99201-99215: Office or other outpatient visits
G0425-G0427: Telehealth consultations, emergency department or initial inpatient
G0406-G0408: Follow up inpatient telehealth consultations furnished to beneficiaries in hospitals or skilled nursing facility (SNF)
Please note: I
n a case where two-way audio and video technology required to furnish a Medicare telehealth service might not be available, there are circumstances where prolonged, audio-only communication between the practitioner and the patient could be clinically appropriate yet not fully replace a face-to-face visit.
For the duration of the PHE for the COVID-19 pandemic, Medicare will make separate payment for
audio-only visits described by CPT codes 98966-98968 and CPT codes 99441-99443 as outlined on page 125 in the Interim Final Rule with Comment.