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  • 30-Mar-2020 7:05 PM | Anonymous member (Administrator)

    Today's virtual Town Hall on Telehealth, Evisits and other telemedicine topics was recorded. The recording and the slides can be found in the members only section.

    Members may view these here.  This will take you to the members only area. You will need to log in using the email address we have on file for you.

  • 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.


    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


    • 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>

  • 25-Mar-2020 11:54 AM | Anonymous member (Administrator)

    From http://www.apta.org/PTinMotion/News/2020/03/18/E-VisitFAQs/

    Recent waivers by CMS that allow for limited digital communication with patients have triggered a wave of questions. Here are our answers to the ones we hear most often.

    APTA is receiving many questions about the recent regulatory waivers announced by CMS related to digital communication between providers and patients, particularly regarding e-visits and the use of HCPCS codes G2061-G2063. We've compiled this list of the most common questions we've received so far.

    If you have a handle on e-visits and just want a brief review of the basics, see our "Quick Reference to Using E-Visits for Physical Therapist Services." But if the new waivers leave you with questions, continue HERE.

    Please note that e-visits are NOT the same as telehealth or telerehab services. Congress and CMS have not modified Medicare to allow physical therapists to the roster of providers who can be reimbursed for telehealth services. With that said, APTA regulatory and payment staff are working directly with CMS and private payers to seek expansion of coverage of telehealth services to include physical therapy services.

    <Read More>

  • 24-Mar-2020 6:05 PM | Anonymous member (Administrator)

    APTA President Sharon Dunn’s letter to the membership about the challenges we’re facing during the COVID-19 epidemic and how we must face them together.

  • 20-Mar-2020 7:03 PM | Anonymous member (Administrator)

    The Office of Civil Rights within the US Department of Health and Human Services has waived the HIPAA requirement for telemedicine. See the excerpt below:

    During the COVID-19 national emergency, which also constitutes a nationwide public health emergency, covered health care providers subject to the HIPAA Rules may seek to communicate with patients, and provide telehealth services, through remote communications technologies.  Some of these technologies, and the manner in which they are used by HIPAA covered health care providers, may not fully comply with the requirements of the HIPAA Rules.

    OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.  This notification is effective immediately.

    Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency.  Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications.

    Under this Notice, however, Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers.


  • 19-Mar-2020 3:00 PM | Anonymous member (Administrator)

    The Listserve has been very busy lately with peer to peer discussions, lately on teleheath and coding, reimbursement. 
    If you are not on this google listserve, be sure to sign up here, or review recent discussion here as well. 


    When you sign up, we need to verify you are a current member, so include your APTA number if you use an email address other than the one we have for you.

  • 19-Mar-2020 10:54 AM | Anonymous member (Administrator)

    Telemedicine is allowed in Montana, and coverage for telemedicine is described in our statutes here: https://leg.mt.gov/bills/mca/title_0330/chapter_0220/part_0010/section_0380/0330-0220-0010-0380.html:

    . “33-22-138. Coverage for telemedicine services. (1) Each group or individual policy, certificate of disability insurance, subscriber contract, membership contract, or health care services agreement that provides coverage for health care services must provide coverage for health care services provided by a health care provider or health care facility by means of telemedicine if the services are otherwise covered by the policy, certificate, contract, or agreement."

    PTs are listed as a health care provider in the definitions.

    Like any other service, it is important to refer to the policy and the contract for each case.

    Before You Begin Practicing Via Telehealth

    The use of telehealth is one approach that can help protect the patient and provider during this time of crisis. Investigate and consider the issues within the following areas as you make decisions on whether or not to use telehealth in your practice. In addition, become familiar with some of the commonly used terms in telehealth.

    Telehealth: Billing and Coding Considerations


    Billing physical therapy services that have been provided through telehealth is an emerging challenge. Due to the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act, the Centers for Medicare and Medicaid Services (CMS) is expanding access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their providers without having to travel to a healthcare facility. For the first time, PTs will be allowed to bill Medicare for telehealth visits under codes associated with online assessment and management services (HCPCS codes G2061: Qualified non-physician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes; G2062: Qualified non-physician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes; G2063: Qualified non-physician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes). Providers must use place-of-service code “02”  and “GT” modifier. The payment rates are significantly lower than the traditional payment for an in-person visit under the CPT 97000 code series. To determine the reimbursement rates for G2061-G2063, visit the CMS Physician Fee Schedule lookup tool. Medicare coinsurance and deductible apply to the services.

    To qualify as an e-visit, three basic qualifications must be met:

    1. The billing practice must have an established relationship with the patient, meaning the provider must have an existing provider-patient relationship;
    2. The patient must initiate the inquiry for an e-visit and verbally consent to check-in services;
    3. The communications must be limited to a seven-day period through an "online patient portal."
    Although the patient must initiate the service, CMS allows "practitioners to educate beneficiaries on the availability of the telehealth service prior to patient initiation." For example, if a patient cancels treatment because they can’t come to the clinic or are concerned about leaving home, then the PT may advise the patient that she or her can “virtually” contact the therapists as needed

    Third-Party Payers

    Payment for telehealth depends on your contract with your payer. There is no list of third-party payers that pay for telerehab. Also confirm with each payer whether the originating site can be a private home or office, if services must be real-time or can be asynchronous, and any other limitations to your use of telehealth.

    For third-party billing, there are "telehealth" CPT codes. But before reporting CPT codes you traditionally use for clinical visits or billing for telephone services (98966-98969), check with your payer. Many of the physical medicine and rehabilitation codes (97000 series) specify "direct 1-on-1 patient contact," which by strict definition would exclude telehealth unless you and your payer have agreed to include these services. A payer also may require an addendum attached to the bill that identifies the service as being provided via telehealth, along with an explanation of the charges, so be prepared to outline the reasoning for using telehealth.

    You also should check with your payer about using place-of-service code "02" when billing for telehealth services to specify the entity where service(s) were rendered. Regardless of the payer or policy, if you provide and bill for services using telehealth, make sure that you are practicing legally and ethically, and are adhering to state and federal practice guidelines and payer contract agreements.

    Montana volunteers will have more about codes next week.


    Two commercial telehealth platforms are eVisit and VisuWell. If you use them, it's a good idea to check their information against the primary sources of state law.

    Read more about Telehealth from APTA: 

    Telehealth in Physical Therapy in Light of COVID-19

  • 19-Mar-2020 10:47 AM | Anonymous member (Administrator)

    For business and employment questions around the handling of this crisis, resources include: 

    1. Department of labor: http://dli.mt.gov/employer-covid-19

    The COVID-19 emergency is now impacting the work and personal lives of Montanans throughout our state. The Montana Department of Labor & Industry is closely following the changing dynamics and policies at the state federal level. This page will be regularly updated to share updated information. Please bookmark this page and check back often.

    Filing for Unemployment Insurance in Montana

    Go to MontanaWorks.gov and click File for Unemployment. From there, you will be directed to login to your MontanaWorks account or create a new account. You can also find valuable resources and services for business and job-seekers on the MontanaWorks.gov portal.


    FAQ for Employers & Employees

    This document is updated daily to reflect the questions we are receiving from employers and employees regarding COVID-19. If you are an employer and have a question that you don’t see answered here, please email: uieservices@mt.gov.

    For employees, if you have a question that you don't see answered here, please email: uiclaims@mt.gov.

    This side-by-side table is a tool for workers and employers to compare various eligibility scenarios including employer-sponsored sick leave, Unemployment Insurance, and Workers’ Compensation coverage. 

    The U.S. Department of Labor also has extensive resources to help workers and employers prepare for and respond to the COVID-19 virus. Their guidance is at:https://www.dol.gov/coronavirus.

    The U.S. Department of Labor has provided guidance to state workforce agencies regarding unemployment compensation flexibilities related to COVID-19. The Program Letter advising states can be found here.

    You may also want to seek the advice of legal counsel.

  • 19-Mar-2020 10:39 AM | Anonymous member (Administrator)
    1. Conduct proper screening procedures for your staff, patients and those individuals accompanying patients to their appointments. Those failing basic screening questions should be redirected back to their home. Identify high risk individuals and follow current guidelines using the information provided by CDC and MT DPHHS
    2. Maintain social distancing in your clinics. This would involve utilizing private treatment rooms and modifying schedules to reduce patient-to-patient interactions.
    3. Maintain the highest sanitary levels via frequent handwashing/sanitizer use and surface disinfection. Inform patients of your procedures via a posted notice at the time of check-in.
    4. Follow guidance from federal, local, and state agencies that may influence how you handle any of the above suggestions. The CDC has provided a resource for getting your practice ready.
    5. Information for healthcare professionals from DPHHS.MT.GOV: 

    From http://dli.mt.gov/employer-covid-19

    Workplace Safety and Health

    Centers for Disease Control and Prevention (CDC):

    Occupational Safety and Health Administration (OSHA):

    U.S. Environmental Protection Agency (EPA):

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