Outpatient Facility Coding Alert - 2021 Issue 3
Telehealth: Learn These Facts, Clear up Telehealth Confusion
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Article Overview
This article explains common telehealth coding and documentation questions that arose during the COVID-19 public health emergency. It summarizes guidance discussed by a Medicare Part B contractor on topics such as documenting virtual visits, payer expectations during the emergency, phone-based evaluation and management services, patient status considerations, place of service, and how telehealth-related claims fit within broader outpatient coding changes. It is useful for coders, billing staff, and clinicians who need to understand current telehealth workflow issues and what may change when emergency flexibilities end.
Why This Topic Matters
Telehealth rules shifted rapidly during the pandemic, creating uncertainty about documentation, claim reporting, and how current temporary policies compare with pre-pandemic requirements. This article helps readers orient themselves to the major telehealth compliance issues affecting Medicare-related billing and virtual care operations.
Article Sections
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First, a Word on Telehealth Documentation and the PHE
Overview of documentation expectations for telehealth encounters during the public health emergency. Discusses general recordkeeping elements and emergency-era billing context.
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Can GE Modifier Allow Residents to Report Phone Codes?
Addresses questions about resident involvement, teaching physician settings, and phone-based services during the public health emergency.
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Can You Differentiate 99441 Series From 98966 Range?
Covers provider-type distinctions for telephone assessment and management services and how those questions were framed during the emergency period.
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Will Practices Eventually Return to Pre-PHE Rules?
Reviews how telehealth policy was expected to change after the public health emergency ended and what broader legal framework was referenced.
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Should You Resubmit Claims That Are Missing Modifier 95?
Discusses claim correction questions and general reimbursement handling related to telehealth reporting during the emergency.
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Can You Determine the POS for an ED Service?
Explains place-of-service questions for emergency department encounters provided via telehealth.
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How Should You Document Time in 2021?
Covers time documentation considerations for telehealth encounters under 2021 evaluation and management documentation expectations.
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Are Telehealth Patients Then Considered “Established?”
Addresses how telehealth encounters relate to new-versus-established patient status under Medicare guidance.
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Can Practices Report Prolonged Service Codes for Phone Calls?
Discusses how prolonged service questions intersect with phone-based evaluation and management reporting and broader outpatient coding changes.
What You Will Learn
- How telehealth documentation was discussed during the COVID-19 public health emergency
- What questions arose about phone-based evaluation and management services
- How provider type and setting affected telehealth billing questions
- What Medicare guidance suggested about post-emergency telehealth policy
- How place of service and time documentation were being handled for virtual care
- How telehealth encounters related to patient status and prolonged service questions
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians
- Nurse practitioners
- Licensed clinical social workers
- Practice managers
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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