Several announcements have been made regarding policies during COVID-19.
CMS has temporarily halted sequestration under Medicare. Starting on May 1, 2020 and extending through December 31st, 2020, CMS will no longer sequester 2% from allowable Medicare payments.
UnitedHealthcare has approved telehealth for therapy providers. This is subject to state laws and regulations around telehealth, but, if permissible, this enables physical therapists, occupational therapists, and speech therapists to provide true telehealth services. Eligible codes will be reimbursed by UHC with a place-of-service code 02 and the 95 modifier.
CIGNA has created telehealth policies for therapy providers. These measures allow for reimbursement of PT services that include codes 97161 (evaluation, low complexity, 20 minutes, telephone or virtual), 97162 (evaluation, moderate complexity, 30 minutes, virtual), and 97110 (therapeutic exercises, two unit limit). Codes must be appended with a GQ modifier and billed with a standard place-of-service code.
Each payer is providing different guidance on how to bill for telehealth services so it is important that they are set up correctly in your EMR system.
If you have any questions about billing for telehealth services (or getting set up to provide it), please don’t hesitate to contact us. We are here to help.