{"id":3851,"date":"2016-08-08T18:38:44","date_gmt":"2016-08-08T18:38:44","guid":{"rendered":"http:\/\/tele.healthcare\/?p=3851"},"modified":"2016-08-08T18:38:44","modified_gmt":"2016-08-08T18:38:44","slug":"cms-proposes-new-medicare-telehealth-coding-rules","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-proposes-new-medicare-telehealth-coding-rules\/","title":{"rendered":"CMS Proposes New Medicare Telehealth Coding Rules"},"content":{"rendered":"

Baby steps, one new POS code granted for telehealth services!!!!\u00a0<\/strong><\/p>\n

August 8, 2016 by\u00a0Nathaniel M. Lacktman and Thomas B. Ferrante<\/p>\n

The Centers for Medicare and Medicaid Services (CMS) issued its proposed Medicare Physician Fee Schedule (PFS) for CY 2017 on July 7, 2016. In it, CMS would require practitioners to use a new place of service (POS) code to report telehealth services. The proposed rule also includes several new covered telehealth services. If enacted, the proposed rules are effective January 1, 2017.<\/p>\n

New Place of Service Code for Medicare Telehealth Services<\/p>\n

Currently, CMS instructs practitioners billing telehealth services to report the POS code that would have been reported had the service been furnished in-person where the beneficiary is located. This rule has generated confusion because some practitioners incorrectly report the POS where they, themselves, are located when the service is furnished. Under the proposed rule, practitioners would report a new \u201ctelehealth\u201d POS code to indicate the service was telehealth service furnished from a distant site.<\/p>\n

The telehealth POS code would not apply to originating sites billing the facility fee. CMS\u2019 reasoned that originating sites are not furnishing a telehealth service as the patient is physically present at the originating site. Accordingly, the originating site would continue to use the POS code that applies to the type of facility where the patient is located.<\/p>\n

New Reimbursement Rate Calculations for Medicare Telehealth Services<\/p>\n

With regard to payment rates for telehealth services under the new POS code, CMS would use the practice expense relative value units (PE RVUs) to pay for telehealth services tagged with the code. There are only three codes on the telehealth services list with a difference greater than 1.0 PE RVUs between the facility PE RVUs and the non-facility PE RVUs. Other than those three codes, payment rates for telehealth services should remain unaffected by the proposed rule. As such, CMS does not anticipate this rule change to significantly change the overall payments for the telehealth services under Medicare. Rather, CMS believes use of this new telehealth POS code will improve payment accuracy and consistency in claims submission.<\/p>\n

New Telehealth Services Under Medicare<\/p>\n

CMS proposed adding eight codes to the list of covered telehealth services. These are:<\/p>\n