Creative delivery of outpatient hospital services during the COVID-19 PHE

June 14th, 2021

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains how COVID-19 public health emergency waivers and Medicare flexibilities affected the delivery of outpatient hospital services through telehealth and other communication-based technology services. It is aimed at hospital outpatient coders, billers, compliance staff, and practitioners who need a high-level understanding of the service categories, participating settings, and related coding frameworks discussed during the PHE.

Why This Topic Matters

During the COVID-19 PHE, hospitals and clinicians had to adapt outpatient service delivery and billing processes to maintain access while reducing exposure risk. Understanding the scope of the waiver-based options and the associated coding categories helps organizations identify which services are addressed in the article and where to look for operational and billing guidance.

Article Sections

  1. Waivers and flexibilities

    Introduces the Medicare waiver framework used during the public health emergency and the general hospital service delivery options discussed in the article.

  2. Telehealth prior to the PHE

    Summarizes the pre-PHE telehealth environment, including the general settings and practitioner types involved.

  3. Telehealth during the PHE

    Covers the emergency-era expansion of telehealth coverage and the related Medicare policy changes described in the article.

  4. Billing for telehealth during the PHE

    Describes the hospital and practitioner billing framework discussed for telehealth services during the public health emergency.

  5. Billing for outpatient therapy services during the PHE

    Addresses the outpatient therapy service delivery approaches referenced for the emergency period.

  6. Other professional CBTS

    Introduces the other communication-based technology services discussed apart from telehealth.

  7. E-visits

    Summarizes the article’s discussion of online digital evaluation and management services and related code families.

  8. Virtual communication services

    Covers brief communication-based services and remote evaluation services described in the article.

  9. Telephone E/M services

    Discusses telephone-based evaluation and management services addressed for the PHE timeframe.

What You Will Learn

  • How the article frames Medicare waivers and flexibilities during the COVID-19 public health emergency
  • Which outpatient service delivery categories are discussed as alternatives to in-person care
  • How telehealth, e-visits, virtual communication services, and telephone E/M services are differentiated at a broad level
  • What types of Medicare billing topics are covered for hospital and practitioner claims during the PHE
  • Which code families and code sets are referenced in the article

Who Should Read This

  • Hospital outpatient coders
  • Medical billers
  • Revenue cycle staff
  • Compliance professionals
  • Health information management professionals
  • Physicians and non-physician practitioners
  • Medicare policy readers

Codes Discussed

  • HCPCS Level II: Q3014
  • CPT: 99421
  • CPT: 99422
  • CPT: 99423
  • HCPCS Level II: G2061
  • HCPCS Level II: G2062
  • HCPCS Level II: G2063
  • CPT: 98970
  • CPT: 98971
  • CPT: 98972
  • HCPCS Level II: G2012
  • HCPCS Level II: G2010
  • HCPCS Level II: G2250
  • HCPCS Level II: G2251
  • CPT: 99441
  • CPT: 99442
  • CPT: 99443
  • CPT: 98966
  • CPT: 98967
  • CPT: 98968

Code Ranges Discussed

  • CPT: 99421-99423
  • HCPCS Level II: G2061-G2063
  • CPT: 98970-98972
  • HCPCS Level II: G2012-G2010
  • HCPCS Level II: G2250-G2251
  • CPT: 99441-99443
  • CPT: 98966-98968

Modifiers Discussed

  • CPT: -95

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