{"id":40503,"date":"2022-08-12T11:40:59","date_gmt":"2022-08-12T15:40:59","guid":{"rendered":"https:\/\/mtelehealth.com\/?p=40503"},"modified":"2022-08-12T11:40:59","modified_gmt":"2022-08-12T15:40:59","slug":"billing-for-rural-telehealth","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/billing-for-rural-telehealth\/","title":{"rendered":"Billing for rural telehealth"},"content":{"rendered":"\n\n\n<p class=\"wp-block-paragraph\">Billing and reimbursement for rural and frontier telehealth services is, in many ways, no different than any other healthcare service. There are also some stark differences.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">On this page:<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/telehealth.hhs.gov\/providers\/telehealth-for-rural-areas\/billing-for-rural-telehealth\/#medicare-and-medicaid-billing-reimbursement\">Medicare and Medicaid billing reimbursement<\/a><\/li><li><a href=\"https:\/\/telehealth.hhs.gov\/providers\/telehealth-for-rural-areas\/billing-for-rural-telehealth\/#medicare-billing-guidance\">Medicare billing guidance<\/a><\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"medicare-and-medicaid-billing-reimbursement\">Medicare and Medicaid billing reimbursement<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The Centers for Medicare &amp; Medicaid Services Office of Minority Health focuses on&nbsp;<a href=\"https:\/\/www.cms.gov\/About-CMS\/Agency-Information\/OMH\/equity-initiatives\/rural-health\">rural health services and providers<\/a>. They also offer&nbsp;<a href=\"https:\/\/www.cms.gov\/About-CMS\/Agency-Information\/OMH\/equity-initiatives\/rural-health\/stay-connected\">regional rural health coordinators<\/a>&nbsp;that can assist with region-specific questions and concerns.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For more information on Medicare billing and coding, see the&nbsp;<a href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/PhysicianFeeSched\">2022 physician fee schedule<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"uninsured-or-underinsured-patients\">Uninsured or underinsured patients<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">While the number of uninsured people in rural areas is falling, there are still&nbsp;<a href=\"https:\/\/www.census.gov\/library\/stories\/2019\/04\/health-insurance-rural-america.html\">more uninsured rural residents than urban residents<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Whether or not a patient can afford to pay for medical care, including appointments, prescriptions, or preventative care measures often depends on their eligibility for state and federal assistance programs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Providers can help by offering free or low cost services, including:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Free vaccination clinics<\/li><li>Free or low cost annual wellness visits<\/li><li>Free or low cost well child visits<\/li><li>Insurance navigators or financial advisors to help patients apply for and maintain Medicaid or Medicare coverage<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">You could also look at offsetting the cost of uninsured or underinsured patients by looking for grants tailored specifically to rural health care providers and clinics.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Read more:<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.cchpca.org\/\">Center for Connected Health Policy<\/a><a href=\"https:\/\/www.hhs.gov\/disclaimer.html\">&nbsp;&nbsp;<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"medicare-billing-guidance\">Medicare billing guidance<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The&nbsp;COVID-19&nbsp;public health emergency led the Center for Medicare and Medicaid Services (CMS) to&nbsp;<a href=\"https:\/\/telehealth.hhs.gov\/providers\/policy-changes-during-the-covid-19-public-health-emergency\/\">expand its coverage for telehealth care<\/a>. Many state Medicaid programs and private insurers are also covering telehealth appointments the same as an in-person appointment, with patients paying their typical co-pays.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Get more information on&nbsp;<a href=\"https:\/\/telehealth.hhs.gov\/providers\/direct-to-consumer\/billing-for-direct-to-consumer-telehealth\/\">billing for direct-to-consumer telehealth<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coding guidance is subject to change. Please refer to the complete&nbsp;<a href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-General-Information\/Telehealth\/Telehealth-Codes\">list of telehealth services<\/a>&nbsp;covered by Medicare during the&nbsp;COVID-19&nbsp;public health emergency from the Centers for Medicare &amp; Medicaid Services.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"maternal-telehealth\">Maternal telehealth<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>Category<\/th><th>Telehealth CPT codes and HCPCS codes<\/th><\/tr><\/thead><tbody><tr><td>Evaluation and monitoring outpatient follow-up<\/td><td>99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215<\/td><\/tr><tr><td>Observation care discharge<\/td><td>99217*<\/td><\/tr><tr><td>Initial observation care<\/td><td>99218, 99219, and 99220 **<\/td><\/tr><tr><td>Initial hospital care<\/td><td>99221, 99222, and 99223 **<\/td><\/tr><tr><td>Subsequent observational care<\/td><td>99224, 99225, 99226<\/td><\/tr><tr><td>Subsequent hospital care<\/td><td>99231, 99232, 99233<\/td><\/tr><tr><td>Telephone evaluation and monitoring service<\/td><td>99441, 99442, 99443<\/td><\/tr><tr><td>Diabetes management<\/td><td>G0108<\/td><\/tr><tr><td>Medical nutrition therapy<\/td><td>97802, 97803<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"annual-wellness-visits\">Annual Wellness Visits<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>Category<\/th><th>Telehealth CPT codes and HCPCS codes<\/th><\/tr><\/thead><tbody><tr><td>Annual wellness visit<\/td><td>G0438, G0439<\/td><\/tr><tr><td>Advanced planning<\/td><td>99497, 99498<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"chronic-care-telehealth\">Chronic care telehealth<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Audio-only or video telehealth<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>Category<\/th><th>Telehealth CPT codes and HCPCS codes<\/th><\/tr><\/thead><tbody><tr><td>Telephone evaluation and management service<\/td><td>99441, 99442, 99443; G0438, G0439<\/td><\/tr><tr><td>Screening, brief intervention, and referral to treatment<\/td><td>G0396, G0397 G0442, G0443, G0444, G0445, G0446, G0447<\/td><\/tr><tr><td>Evaluation and monitoring outpatient follow-up<\/td><td>99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215<\/td><\/tr><tr><td>Observation care discharge<\/td><td>99217 *<\/td><\/tr><tr><td>Initial observation care<\/td><td>99218, 99219, 99220 **<\/td><\/tr><tr><td>Subsequent observational care<\/td><td>99224, 99225, 99226<\/td><\/tr><tr><td>Opioid use disorder treatment<\/td><td>G2086, G2087, G2088<\/td><\/tr><tr><td>Alcohol and substance abuse assessment<\/td><td>G0396, G0397<\/td><\/tr><tr><td>Diabetes Care Management: Phone evaluation and management<\/td><td>99441, 99442, 99443<\/td><\/tr><tr><td>Diabetes self-management training<\/td><td>G0108, G0109<\/td><\/tr><tr><td>Medical nutrition therapy<\/td><td>97802, 97803, 97804, G0270<\/td><\/tr><tr><td>Psychotherapy<\/td><td>90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838<\/td><\/tr><tr><td>Renal Care: Phone evaluation and management<\/td><td>99441, 99442, 99443<\/td><\/tr><tr><td>Renal Care: Outpatient dialysis services<\/td><td>90951, 90952, 90953, 90954, 90955, 90956, 90957 ,90958, 90959, 90960, 90961, 90962<\/td><\/tr><tr><td>Renal Care: Hospital care services, with the limitation of 1 telehealth visit every 3 days<\/td><td>99231, 99232, 99233<\/td><\/tr><tr><td>Renal Care: Individual and group kidney disease education<\/td><td>G0420, G0421<\/td><\/tr><tr><td>Renal Care: Transitional care management services<\/td><td>99495, 99496<\/td><\/tr><tr><td>Renal Care: Advance care planning<\/td><td>99497, 99498<\/td><\/tr><tr><td>Renal Care: Prolonged service<\/td><td>99354, 99355, 99356, 99357<\/td><\/tr><tr><td>Renal Care: Telehealth consultations, critical care<\/td><td>G0508, G0509<\/td><\/tr><tr><td>Pulmonary Care: Phone evaluation and management<\/td><td>99441, 99442, 99443<\/td><\/tr><tr><td>Pulmonary Care: Rehabilitation<\/td><td>94625, 94626, G0424<\/td><\/tr><tr><td>Pulmonary Care: Transitional care management services<\/td><td>99495, 99496<\/td><\/tr><tr><td>Pulmonary Care: Advance care planning<\/td><td>99497, 99498<\/td><\/tr><tr><td>Pulmonary Care: Prolonged service<\/td><td>99354, 99355, 99356, 99357<\/td><\/tr><tr><td>Pulmonary Care: Ventilator management<\/td><td>94002, 94003, 94004, 94005<\/td><\/tr><tr><td>Pulmonary Care: Evaluate patient use of inhaler<\/td><td>94664<\/td><\/tr><tr><td>Cardiac Care: Phone evaluation and management<\/td><td>99441, 99442, 99443<\/td><\/tr><tr><td>Cardiac Care: Transitional care management services<\/td><td>99495, 99496<\/td><\/tr><tr><td>Cardiac Care: Advance care planning<\/td><td>99497, 99498<\/td><\/tr><tr><td>Cardiac Care: Prolonged service<\/td><td>99354, 99355, 99356, 99357<\/td><\/tr><tr><td>Cardiac Care: Cardiac rehab<\/td><td>93797, 93798, G0422, G0423<\/td><\/tr><tr><td>Cardiac Care: In-person ventricular assist device interrogation<\/td><td>93750<\/td><\/tr><tr><td>Stroke and Rehabilitation Care: Phone evaluation and management<\/td><td>99441, 99442, 99443<\/td><\/tr><tr><td>Physical Therapy Services<\/td><td>97161, 97162, 97163, 97164, 97110, 97112, 97116, 97150, 97530, 97535, 97542, 97750, 97755, 97760, 97761, G2061, G2062, G2063<\/td><\/tr><tr><td>Occupation Therapy Services<\/td><td>97165, 97166, 97167, 97168<\/td><\/tr><tr><td>Speech Therapy<\/td><td>92507, 92508, 92521, 92522, 92523, 92524, 92526<\/td><\/tr><tr><td>Aphasia Assessment<\/td><td>96105<\/td><\/tr><tr><td>Cancer Care: Phone evaluation and management<\/td><td>99441, 99442, 99443<\/td><\/tr><tr><td>Cancer care: Radiation oncology treatment management<\/td><td>77427<\/td><\/tr><tr><td>Dementia Care: Phone evaluation and management<\/td><td>99441, 99442, 99443, G0438, G0439<\/td><\/tr><tr><td>Dementia Care: Cognitive assessment and care plan services<\/td><td>99483<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">*Remains available until December 31, 2023<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">**Will expire at some point after the&nbsp;COVID-19&nbsp;public health emergency is declared over<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Billing and reimbursement for rural and frontier telehealth services is, in many ways, no different [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":40498,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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