News

APTA's flagship telehealth page is now enhanced with news and frequent updates related to COVID-19 changes, including use of digital “e-visits” and the status of state and payer policies related to eligibility to practice and coverage of telehealth, as well as template letters to help you advocate to CMS, states, and payers to waive telehealth restrictions.

http://www.apta.org/Telehealth/?_zs=uL3fV1&_zl=RFpe6

In a letter to Alpine PT in Missoula, BCBSMT stated:

"BCBSMT covers telemedicine services provided by physical therapists under the terms and conditions set out in 33-22-138, MCA. In addition, due to the COVID-19 public health emergency, BCBSMT is temporarily enhancing our telehealth benefits beyond the requirements of 33-22-138, MCA.
"Retroactive to February 4, 2020, we will compensate participating providers for secure interactive audiovideo covered telemedicine services at the same rates allowed for an in-person office visit. We are also temporarily expanding telehealth coverage to audio-only telephone calls (see our April 1, 2020 Blue News announcement for more details and compensation information for audio-only telephone covered services), and we are temporarily waiving member cost-sharing for all in-network covered telemedicine services until April 30, 2020. These business decisions will be re-evaluated as necessary, as the COVID-19 public health emergency progresses."

These articles were distributed by JCCS, a CPA firm in Montana. They explain how these Relief Packages may help you.

• CARES Act – SBA Relief Options
• Families First Coronavirus Response Act

Today, CMS issued a wide range of temporary regulatory waivers and new rules to respond to the COVID-19 public health emergency. APTA staff are currently reviewing what it means for PTs and PTAs who work across the care continuum. APTA will follow up with more details tomorrow.

https://www.cms.gov/newsroom/press-releases/trump-administration-makes-sweeping-regulatory-changes-help-us-healthcare-system-address-covid-19

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.

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 3^rd 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 3^rd 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 3^rd party payers. I am looking into Google Meet, doxy.com, vsee.com (non HIPAA compliant platforms that work well are LifeSize Video, Facetime, Zoom>

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>

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.

https://ppsapta.org/physical-therapy-covid-19.cfm

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.

https://www.hhs.gov/about/news/2020/03/17/ocr-announces-notification-of-enforcement-discretion-for-telehealth-remote-communications-during-the-covid-19.html