Telehealth: Master New Guidance for COVID-19 Telehealth Exceptions

Why This Topic Matters

Telehealth billing rules changed quickly during the COVID-19 public health emergency, and claims needed to reflect temporary CMS instructions accurately. Understanding the article helps practices reduce denials and apply the correct general telehealth reporting framework for Medicare beneficiaries.

Article Sections

1. Code for Telehealth Visits

   Explains the general Medicare telehealth framework during the public health emergency and discusses service categories and reporting considerations for remote visits. It also references CMS guidance and the broader telehealth service list.

2. Communication

   Covers the technology and communication format expected for telehealth encounters, including the types of interactive systems mentioned in CMS guidance. It also notes the role of commonly used apps and platform waivers during the emergency period.

3. Not telephone

   Addresses the distinction between audio-video telehealth encounters and audio-only interactions under the temporary Medicare guidance. It explains that not all remote communications are treated the same for billing purposes.

4. MDM

   Summarizes how medical decision making and time were discussed in relation to telehealth office/outpatient service selection during the emergency period. It also ties the discussion to broader 2021 evaluation and management changes.

5. Understand Modifiers

   Reviews modifier considerations associated with telehealth claims during the public health emergency and notes that payer requirements can vary. The section also discusses CMS-related modifier usage contexts.

6. Follow Correct POS Instruction

   Explains place-of-service reporting concepts for Medicare telehealth claims during the public health emergency and distinguishes temporary telehealth reporting from traditional originating-site telehealth. It also references how location reporting relates to different visit settings.