Telemedicine Services Are Here to Stay Thanks to COVID-19, Shows Telehealth Billing Statistics

telehealth billing

The number of telehealth visits via real-time audio-video communication, as well as audio-only phone calls, skyrocketed in 2020, telehealth billing statistics show, due to the outbreak of SARS-CoV-2 and stay-at-home orders nationwide. Nearly half (43.5%) of Medicare primary visits were done via telehealth in April, compared to just 0.1% in February prior to the public health emergency (ASPE-HHS, 2020).

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Eleven New Telehealth Services Added to Medicare Reimbursement List

list of medicare telehealth services

CMS has added 11 new services to the Medicare telehealth services list. These new services focus on specific neurostimulator analysis and programming, and cardiac and pulmonary rehabilitation (CMS, 2020). There have been over 135 services added to the list of payable Medicare telehealth services since CMS started expanding Medicare coverage, including ED visits and inpatient encounters. Review our Telehealth Resource Center for the full list of revised coding and billing guidelines for COVID-19. If your facility is struggling with deciphering the revised telehealth guidelines, contact YES HIM Consulting for coding support from our HIM-credentialed experts.

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How to Overcome These Common Challenges in Telehealth Coding & Billing

Knowing how to accurately code and bill telemedicine services has been one of the biggest telehealth problems that practices are running into due to the amount of policy changes released over a short time period and the lack of experience in documenting these services. Here are the other most common challenges in telehealth and most popular questions about telemedicine.

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CMS Guidelines for Telehealth Coding & Billing During PHE

CMS guidelines for telehealth

The Centers for Medicare & Medicaid Services (CMS) has decided to update the CMS billing and coding guidelines for telehealth or in-home provider services due to the urgency of the current 2019-Novel Coronavirus (COVID-19) pandemic (CMS, 2020). CMS has broadened the scope for reimbursement for virtual check-ins and other digital communications with patients to safely and effectively respond to this Public Health Emergency (PHE). In the interim, telehealth services will not be limited by program restrictions put in place by Medicare (Federal Register, 2020). Evaluation and management (E/M) service codes cover these remote and communication technology-based services performed by a physician or non-physician practitioner (NPP).

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Medicare Telehealth Services Now Included In Expanded Payment Protocol

medicare telehealth services

The Centers for Medicare & Medicaid Services (CMS) has decided Medicare will expand its payment protocol for professional Medicare telehealth services provided to beneficiaries in all areas of the country, in all settings. “Telehealth, telemedicine, and related terms generally refer to the exchange of medical information from one site to another through electronic communication to improve a patient’s health” (CMS, 2020). Due to the current Public Health Emergency (PHE) declared for 2019 Novel Coronavirus (COVID-19), this expansion was considered a necessary step to assist in healthcare reimbursement and only designed to last as long as this emergency

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Telemedicine Guidelines & COVID-19: Coding in Response to the 1135 Waiver Authority

telemedicine guidelines

Due to the stay-at-home orders put in effect by state governors and the highly contagious COVID-19 virus, CMS has expanded coverage for its Medicare recipients through the use of telemedicine (CMS, 2020). According to CMS, “The benefits are part of the broader effort by CMS and the White House Task Force to ensure that all Americans – particularly those at high-risk of complications from the virus that causes the disease COVID-19 – are aware of easy-to-use, accessible benefits that can help keep them healthy while helping to contain the community spread of this virus” (2020).

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CMS Increases List of Payable Medicare Telemedicine Services


Adapting to the influx of telehealth services in response to the COVID-19 outbreak, CMS has adjusted the “List of services payable under the Medicare Physician Fee Schedule when furnished via telehealth” in order to provide as much support and care as possible (2020). In addition, CMS issued updated criteria for risk adjustment of Medicare telemedicine services, as well as guidelines on how to bill for telemedicine.

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