This page will serve as our primary landing point for all news related to the global pandemic! Please bookmark and check back often for new information. We will load the newest information at the top for your convenience.

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We are fortunate to be able to be open during the pandemic

PSS offices will be running on the normal schedule, Monday through Friday from 9am until 5pm during the global pandemic. We encourage all of our clients to stay safe and use appropriate precautions not to spread this illness so that as a nation we can recover quickly, and so that we endanger as few people as possible.

4/9/2020

CMS Telehealth Toolkits (released 3/23/2020):

General Practitioners: https://www.cms.gov/files/document/general-telemedicine-toolkit.pdf

End-Stage Renal Disease Providers: https://www.cms.gov/files/document/esrd-provider-telehealth-telemedicine-toolkit.pdf
AMA Toolkit (released 3/27/2020):
•https://www.ama-assn.org/system/files/2020-03/covid-19-coding-advice.pdf

CMS on April 3, 2020 notified all providers via Special Edition Message that it has made another alteration in the coding requirements for Telemedicine /Telehealth services.

Highlighted below are the most critical changes, which relate to POS (Place of service) and modifier usage.

Earlier Notification Latest Notification
Place of Service (POS) Traditional Medicare telehealth services professional claims should reflect the designated POS code 02-Telehealth, to indicate the billed service was furnished as a professional telehealth service from a distant site. Claims billed with a POS of 02 will be paid at the facility rate. Place of Service (POS) equal to what it would have been had the service been furnished in-person
E.g. Physicians can use POS 11 as if the service is being provided in the an office setting
Modifier, no specific modifier mandatorily required. Modifier 95, indicating that the service rendered was actually performed via telehealth. CMS is not requiring the “CR” modifier on telehealth services.

Source:

Friday, April 3, 2020, to read “Billing for Professional Telehealth Distant Site Services During the Public Health Emergency — Revised”

Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. Click here to view the full list of services.

4/1/2020

CMS Issues Regulatory Waivers Surrounding Telehealth

Last night, the Centers for Medicare & Medicaid Services (CMS) issued a series of temporary regulatory waivers to further support the ability of the nation’s healthcare system to respond to COVID-19. The changes outlined below will take effect immediately across the entire country:

  • New telehealth codes. CMS will pay for 80 additional telehealth codes, including home visits, emergency department visits, and therapy services. Providers can waive copayments for all telehealth services for Original Medicare beneficiaries.
  • Virtual check-ins. Clinicians can provide virtual check-in services (HCPCS G2012, G2010) to both new and established patients. Previously, these services were limited to established patients only.
  • Telephone codes. CMS will reimburse for telephone evaluation and management services provided by a physician (CPT 99441-99443) and telephone assessment and management services provided by a qualified nonphysician healthcare professional (CPT 98966-98968). These codes are only available to established patients but may be furnished using audio-only devices.
  • E-visits. Licensed clinical social workers, clinical psychologists, physical therapists, occupational therapists, and speech language pathologists can provide e-visits (HCPCS G2061-G2063). These codes are only available to established patients and must be initiated by the patient.
  • Removal of frequency limitations on Medicare telehealth. Subsequent inpatient visits (CPT 99231-99233), subsequent skilled nursing visits (CPT 99307-99310), and critical care consult codes (CPT G0508-G0509) no longer have limitations on the number of times they can be billed.
  • Medicare physician supervision requirements. Physician supervision can be provided virtually using real-time audio/visual technology for services requiring direct supervision by a physician or other practitioner.
  • “Stark Law” waivers. CMS is implementing waivers that exempt providers from sanctions for noncompliance of certain Stark Law rules, permitting certain referrals and the submission of related claims that would otherwise violate the Stark Law.
  • MIPS flexibilities. CMS will allow clinicians adversely affected by COVID-19 to submit an application to request reweighting of the MIPS performance categories for the 2019 performance year.

03/30/20 Advance on Medicare Payments

The CMS this weekend specified how providers can access accelerated or advanced Medicare payments under the new economic stimulus package.

The Coronavirus Aid, Relief, and Economic Security Act (CARES), that was signed into law by President Donald Trump on Friday, facilitates all Medicare providers to tap into a backup reserve in order to shore up their cash flows.

CMS Administrator Seema Verma stated. “With our nation’s healthcare providers on the front lines in the fight against COVID-19, dollars and cents shouldn’t be adding to their worries. Unfortunately, the major disruptions to the healthcare system caused by COVID-19 are a significant financial burden on providers. Today’s action will ensure that they have the resources they need to maintain their all-important focus on patient care during the pandemic.

Typically, the CMS only makes such a move to assist providers impacted by a natural disaster. But Saturday’s modification pertains to all hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers as well as suppliers.

  1. Eligibility: According to CMS, providers or suppliers must:
  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form
  • Not be in bankruptcy
  • Not be under active medical review or program integrity investigation, and
  • Not have any outstanding delinquent Medicare overpayments
  1. Amount of Payment: Qualified providers/suppliers can request up to 100% of the Medicare payment amount for a three-month period.
  2. Time: MAC will begin to accept and start managing requests immediately and said payments would be dispensed as early as within 7 days.
  3. Repayment: CMS has extended the repayment of these accelerated/advance payments to begin 120 days after the date of issuance of the payment.
  4. Claim Submission: Providers can submit claims as usual after the advance payment has been issued to them. Providers/ suppliers will receive full payments for their claims during the 120-day delay period.
  5. Recoupment will begin after 120 days from the provider’s/supplier’s claim payment amount

For detailed process on how to Request Accelerated or Advance Payment, please click on CMS release

(03/26/20) AMA Coding guidelines released on Covid-19

New guidance from the AMA provides special coding advice during the COVID-19 public health emergency. One resource outlines coding scenarios designed to help health care professionals apply best coding practices. The scenarios include telehealth services for all patients.
Examples specifically related to COVID-19 testing include coding for when a patient:
  • comes to the office for an E/M office visit and is tested for COVID-19
  • receives a telehealth visit regarding COVID-19
  • is directed to come to a physician’s office or physician’s group practice site for testing
  • receives a virtual check-in/online visit regarding COVID-19 (not related to an E/M visit)
  • is directed to come to a physician’s office for testing
There is also a quick-reference flowchart that outlines Current Procedural Terminology (CPT®) reporting for COVID-19 testing. A new web page on the AMA site also outlines CMS payment policies and regulatory flexibilities related to COVID-19. Check the AMA COVID-19 resource center to stay up to date and for additional resources.

(03/26/20) Iceland has tested the highest percentage of their population, and find that 50% of those who tested positive were completely, or partially asymptomatic.

As a small business owner myself, I am no stranger to worrying about the livelihood of all of our businesses. It’s easy to write off this pandemic as being over-hyped and our growing number of shelter in place orders to be a step too far, but if there is any indication of why it is important to shelter in place even when we feel fine, that clue comes from the nation who has managed to test more of its citizens per-capita than anywhere else in the world, and their findings are telling. According to this article out of Iceland, half of those who tested positive for the virus show no signs. This is much higher than our own CDC studies suggesting that almost 20% of us could be asymptomatic and never show signs that we are infecting those around us!