Guidelines: Understand Telehealth by Studying These 3 Scenarios

Why This Topic Matters

Telehealth coding requirements have shifted over time and can differ by payer, so this topic is important for accurate reporting and compliance. Understanding the scope of the article helps readers quickly determine whether they need the full guidance for telemedicine, telephone-based services, and online digital encounters.

Article Sections

1. Scenario 1: Telemedicine via two-way video and audio

   Covers a real-time telemedicine encounter and discusses how the article frames Medicare and private payer reporting considerations before and during the public health emergency. The section also references place-of-service concepts, telehealth platforms, and related policy sources.

2. Coding alert 1: Pre-PHE originating site exceptions

   Summarizes the article’s discussion of special situations that affected where telehealth services could be furnished under Medicare before the public health emergency. The section focuses on high-level exceptions and affected patient groups.

3. Scenario 2: Telephone service and virtual check-in

   Describes a telephone-based patient interaction and contrasts the general categories of reporting discussed for telephone services and brief virtual communication services. The section also notes that the guidance varies by time and practitioner type.

4. Coding alert 2: Service timing and related-visit limitations

   Addresses the article’s caution about when certain telecommunication services are not separately reported because of related encounters. The section presents the timing topic at a general level.

5. Pro coding tip: Services by qualified nonphysician health care professionals

   Introduces a separate reporting path for communications furnished by qualified nonphysician practitioners. The section explains that the article distinguishes these services from physician or other qualified health care professional reporting.

6. Scenario 3: Online digital evaluation and management

   Covers secure digital messaging between an established patient and provider and discusses the article’s broad treatment of online digital assessment and management services. The section also mentions time-based reporting and payer preference considerations.

7. Coding alert 3: Establishment, initiation, and related E/M services

   Summarizes the article’s discussion of patient status, who initiates the contact, and how related evaluation and management services affect reporting. The section also references temporary policy changes discussed in the source.