Over the past two months, telehealth usage has spiked to new heights as healthcare providers try to balance patient needs for care while following prescribed preventative measures to reduce the spread of the COVID-19 virus. As government agencies begin to ease restrictions, it is making it easier for providers to deliver care remotely and positively impact patients in many ways.
The Office of Civil Rights (OCR) at the Department of Health and Human Services (HHS) took several steps to make telehealth services more accessible to patients by exercising its enforcement discretion and choosing not to impose penalties against good faith use by healthcare providers of non-HIPAA compliant apps. That includes allowing smartphones as telehealth devices, as well as allowing physicians to interact with patients with several consumer apps during the pandemic. To facilitate healthcare delivery, apps like Facebook Messenger, FaceTime, Google Hangouts, and Skype are temporarily allowed, even though they may not be HIPAA-compliant. Providers may use these services as long as they are not public-facing applications.
There are also a number of video communications services that represent themselves as being HIPSSA-compliant including Microsoft Teams, Zoom for Healthcare, Cisco WebEx, GoToMeeting, Google G Suite Hangouts Meet, and others.
In addition to relaxing privacy requirements during the current crisis, CMS has also lifted location requirements to allow providers to deliver telehealth services to patients in their homes, regardless of whether they are new or existing patients. It also is allowing cross-border interactions, provided the involved states also have approved these concessions. In many cases, doctors may perform supervisory functions via telehealth, which normally would require their physical presence.
In conjunction with the changes and waivers granted by state and federal authorities, CMS has also implemented 85 new, temporary CPT codes to facilitate appropriate reimbursement for expanded telehealth services during the pandemic. These codes make it easier for providers to bill for services rendered, providing additional motivation for implementing broader telehealth strategies and making critical healthcare services accessible for patients during a challenging time.
Services impacted by the new, temporary codes include:
- Radiation treatment management services (77427)
- Psychological and neuropsychological testing (96130- 96133, 96136- 96139)
- Therapy services, physical and occupational therapy (97161- 97168, 97110, 97112, 97116, 97535, 97750, 97755, 97760, 97761, 92521- 92524, 92507)
- Initial and subsequent observation and observation discharge day management (99217- 99220, 99224- 99226, 99234- 99236)
- Initial hospital care and hospital discharge day management (99221-99223, 99238- 99239)
- Emergency Department visits (99281-99285)
- Critical care services (99291-99292)
- Initial nursing facility visits and nursing facility discharge day management (99304-99306, 99315-99316)
- Domiciliary, rest home, or custodial care services for new and established patients (99327- 99328, 99334-99337)
- Home visits for new and established patients (99341- 99345, 99347- 99350)
- Initial and Subsequent inpatient neonatal and pediatric critical care (99468- 99473, 99475- 99476)
- Initial and continuing intensive care services (99477- 994780)
- Care planning for patients with cognitive impairment (99483)
AMA has a complete list of telehealth CPT codes, including the new codes expanding services during the current pandemic.
These changes provided much-needed flexibility to help healthcare providers manage the surge in demand, including an influx of COVID-19 patients. They also enable systems in overburdened geographies to engage healthcare professionals in other locations to supplement their local staff and increase their capacity to deliver care. At the same time, these concessions ensure patients have access to healthcare services without exposing either themselves or their physicians to unnecessary risk. This is particularly important for patients suffering from chronic conditions who can receive uninterrupted care through telehealth or remote patient monitoring services.
While it remains to be seen if the CMS and HHS will roll back these changes, the fact is they are currently providing access to healthcare services, while helping providers meet the COVID-19 challenge head-on. At the very least, both providers and patients are becoming more informed about the capabilities and benefits of connected health, which will hopefully lead to increased adoption once conditions return to normal.
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*The information contained in this blog is provided for educational purposes only and is not intended to replace discussions with a physician or other healthcare provider or your legal counsel.