Telehealth Services for Physical, Occupational, Speech ...

Telehealth Services for Physical,

Occupational, Speech Therapy & E-VISITS:

During the COVID-19 Pandemic

Telehealth Services:

Outpatient PT/OT/SLP codes included as part of the temporary expansion of telehealth services as a result of the COVID-19 public health emergency. This change is effective immediately for dates of services March 18, 2020 through May 31, 2020.

? Must be an established patient ? Must have open physician order. RX doesn't have to state telehealth. ? Limit: 2 units allowed per day; no more than 3 times a week. ? Treatment should be appropriate based on the claimant's injury; the claimant

should be receiving appropriate treatment and moving towards a home exercise program.

o Example: TheraBand's should not be billed every day. ? Reviewers need to be using their best judgement to prevent waste & abuse. ? Do not allow initial evaluations.

o If the patient has an acute injury or recent surgery, they should be referred to a home health agency. These initial evaluations should be done one on one.

ANF: The place of service=02 Price per providers GEO zip code in box 32. WC: The place of service=02 Price per the WC fee schedule, contracts should be paid at contract rate.

EDavis March 26, 2020 EDavis Mach 30, 2020 Added Telehealth Cigna/medicalDbwcCOVID-19.html

Re-evaluation for PT/OT: Therapist may bill for an appropriate re-evaluation in addition to the two units of exercises per day.

Physical Therapy; (exercises - 2-unit limit): ? 97164 ? Re-evaluation ? 97110 ? Therapeutic exercises ? 97112 ? Neuromuscular reeducation ? 97116 ? Gait Training (includes stair climbing) ? 97530 ? Therapeutic activities ? 97535 ? Self-care/home management training

Occupational Therapy: (exercises ? 2-unit limit): ? 97168 ? Re-evaluation ? 97110 ? Therapeutic exercises ? 97530 ? Therapeutic activities ? 97112 ? Neuromuscular reeducation ? 97535 ? Self-care/home management training

Speech Therapy: ? 92507 ? Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual ? 92526 ? Treatment of swallowing dysfunction and/or oral function for feeding ? 97129 ? Cognitive function first 15 minutes (1-unit limit) ? 97130 ? Cognitive function additional 15 minutes (1-unit limit)

Vocational Services: Deny these bills with reason code: 03 Bill note: This service is not allowed via telehealth.

EDavis March 26, 2020 EDavis Mach 30, 2020 Added Telehealth Cigna/medicalDbwcCOVID-19.html

E-VISITS: The following policy is approved by CMS and is currently being adapted by other commercial carriers. Please note we are checking daily for updates and will provide changes as necessary during the Coronavirus emergency.

This policy is in effect only during the COVID-19 crisis.

E-visits are not the same as Telehealth: 2020 PFS final rule: CMS describes e-visits as "non face-to-face patient-initiated digital communications that require a clinical decision that otherwise typically would have been provided in the office." Typically, E-visits are done through secure platforms, such as EHR portal, email, or other digital applications.

E-visit Rule: ? Must be established patient. ? Place of service is the providers address

Providers who qualify to bill E-visits: ? Physical Therapist ? Occupational Therapist ? Speech Language Pathologists

Allowable CPT/HCPCS Codes & Pricing: Auto:

? 98970/G2061: Time spent: 5-10 minutes. 98971/G2062: Time spent: 11-20 minutes. 98972/G2063: Time spent: 21 or more minutes.

**The above codes are time based, and only billed once during a 7-day period**

EDavis March 26, 2020 EDavis Mach 30, 2020 Added Telehealth Cigna/medicalDbwcCOVID-19.html

Workers Compensation: ? 98970/G2061: Time spent: 5-10 minutes. ? 98971/G2062: Time spent: 11-20 minutes. ? 98972/G2063: Time spent: 21 or more minutes.

**The above codes are time based, and only billed once during a 7-day period**

If bills come in with other HCPCS/CPT codes: Deny these bills with reason code: OO Bill Note: Please rebill the proper E-visit code.

Vocational Services: Deny these bills with reason code: 03 Bill note: This service is not allowed via E-visit.

EDavis March 26, 2020 EDavis Mach 30, 2020 Added Telehealth Cigna/medicalDbwcCOVID-19.html

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