Virtual Visits Reimbursement

Webinar Update – April 10, 2020

On April 9, 2020, CMS clarified that providers may render telehealth services from their homes in the COVID-19 Interim Final Rule FAQs posting available at https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf. The following applies:

14. Question: Can the distant site practitioner furnish Medicare telehealth services from their home? Or do they have to be in a medical facility?

Answer: There are no payment restrictions on distant site practitioners furnishing Medicare telehealth services from their home during the public health emergency. The practitioner should report the place of service (POS) code that would have been reported had the service been furnished in person. This will allow our systems to make appropriate payment for services furnished via Medicare telehealth which, if not for the PHE for the COVID-19 pandemic, would have been furnished in person, at the same rate they would have been paid if the services were furnished in person. New: 4/9/20

Webinar Description

With mandates to cancel elective patient care encounters, directives to maximize social distancing, and imperatives to conserve PPE, health systems and practices have hastily explored the ability to meet patient needs via virtual visits. Expansion of reimbursement parameters and relaxation of restrictions by CMS – and pressure on commercial payers to do the same – makes virtual care more realistic and at least partially mitigates potential lost revenue.

Simply meeting patient needs is the easiest part of this transition. Systemic changes are needed to ensure adequate documentation of not only the care provided but also to ensure that reimbursement requirements are satisfied – and that this mode of care can be continued well into the future.

In this webinar, HSG will share what we have learned from the regulatory changes and from working with clients where we have “boots on the ground” helping them run network operations.

Learning Objectives

  1. Understand the processes that must be managed to successfully implement virtual visits.
  2. Focus on revenue cycle requirements to ensure collections are received for care rendered.
  3. Be aware of conditions expected to sustain virtual visits after the pandemic.

Presenters

  • Terrence McWilliams, M.D., Director and Chief Clinical Consultant
  • Kelle Humphries, Director

Terrence R. McWilliams, MD, FAAFP

Chief Clinical Officer and Managing Director, Employed Provider Networks