HCPro, JustCoding Outpatient - 2020 Issue 28 (July)
COVID-19 coding update: Unpack the latest guidance for reporting outpatient telehealth services
July 28th, 2020
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Article Overview
This article explains recent CMS guidance affecting hospital billing for outpatient telehealth, virtual clinic visits, and related services during the COVID-19 public health emergency. It is aimed at hospital coders, outpatient reimbursement staff, and compliance teams who need to understand how CMS FAQ updates relate to provider-based departments, therapy and other non-OPPS services, and OPPS-covered services furnished in relocated or excepted settings.
Why This Topic Matters
The guidance discussed in the article affects how hospitals report and are paid for virtual outpatient services under COVID-19 flexibilities. Understanding the update helps readers track CMS FAQ changes, identify which broad service categories are addressed, and recognize where clarification is still being sought.
Article Sections
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Non-OPPS services
Discussion of outpatient services that are not paid under OPPS and the broad CMS guidance updates related to virtual delivery and provider-based department reporting. The section focuses on general billing considerations for therapy and other non-OPPS outpatient services.
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OPPS services
Overview of CMS guidance for OPPS-covered services furnished in on-campus or excepted off-campus provider-based departments during the public health emergency. The section addresses relocation-related reporting topics, virtual service billing, and areas where additional CMS clarification is being requested.
What You Will Learn
- How the article frames CMS COVID-19 FAQ updates for outpatient telehealth reporting
- Which broad categories of outpatient services are discussed as non-OPPS versus OPPS
- What provider-based department and relocation topics are highlighted in the guidance
- Why the article emphasizes the need for additional CMS clarification on virtual service reporting
Who Should Read This
- Hospital outpatient coders
- Reimbursement and billing staff
- Compliance professionals
- Revenue cycle managers
- Healthcare consultants
Codes Discussed
Modifiers Discussed
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