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>