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Notes from Christian Appel on Telehealth vs. E-visits

25-Mar-2020 1:43 PM | Anonymous member (Administrator)

THIS WILL EVOLVE OVER TIME. This as of 3/24/20. If you have more to share, please send it to this office or to Christian.

E-Visit

1) The patient must initiate the need for an E-visit

2) The 7 days begins when the provider provides first E-visit

3) A G-code is billed at the end of the 7 day time frame based on total time spent with patient during that 7 day time period

4) G2061 5-10 min, G2062 11-20 min, G2063 21 min or more (this is cumulative time during the 7 days)

5) Due not use place of service code "02" for E-visits. Use place of service for where the provider is located

6) Use CR modifier

7) The APTA is seeking clarity from CMS what occurs after the 7 day time period.

8) Cannot perform an evaluation, only appropriate to use with established patients

9) Medicare and Aetna (Medicaid, Tricare ?)

10) Telephone or 2-way telecommunications are appropriate

11) President has temporarily relaxed HIPAA requirements

Telehealth

  • 1)    BCBS, Pacific Source, most private 3rd party payers
  • 2)    Billed each visit
  • 3)    Use normal CPT codes (obviously not manual therapy)
  • 4)      Use GT modifier (indicate a service was rendered via synchronous telecommunication.)
  • 5)      My understanding can use place of service “11” office or “12” home. “02” Telehealth does not seem to be necessary with GT modifier
  • 6)    Most 3rd party payers are requiring use of HIPAA platform requirements. It is unclear if the President’s order to relax HIPAA requirements for Telehealth extends to private 3rd party payers. I am looking into Google Meet, doxy.com, vsee.com (non HIPAA compliant platforms that work well are LifeSize Video, Facetime, Zoom>


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