CMS released it’s latest MLN on telehealth services in February of this year. The additions include the new codes allowed for CY2024, the new and expanded telehealth services, extended use of modifier -95, and the originating site facility fee for CY2024.
The new codes for this year include:
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The temporary addition of CPT® Category III codes 0591T-0593T for health and well-being coaching services
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The permanent addition of HCPCS Code G0136 for Social Determinants of Health Risk Assessment
o This code was released as a part of the CMS Final Rule. You can read more about this new code here.
Expansions include:
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Telehealth originating sites for services provided via telehealth now include any site in the U.S. where the patient is at the time of telehealth services, including their home.
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Qualified occupational therapists (OTs), physical therapists (PTs), speech-language pathologists (SLPs), and audiologists are now included in the definition of telehealth practitioners.
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Mental health counselors and marriage and family therapists have been added as distant site practitioners for the purpose of providing telehealth services.
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Rural health clinics (RHCs) and federally qualified health centers (FQHCs) may continue to receive payment for telehealth services provided using the methodology established for those telehealth services during the PHE.
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A delay to the requirement for an in-person visit with the physician or practitioner within 6 months before initiating mental health telehealth services.
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Teaching physicians may use audio or video real-time communications technology when the resident provides Medicare telehealth services in all residency training locations
o Through the end of CY2024
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The removal of frequency limitations for CY2024 in the following settings:
o Subsequent inpatient visits
o Subsequent nursing facility visits
o Critical care consultations
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Allowance for hospitals and other providers of PT, OT, SLP, diabetes self-management training (DSMT) and medical nutrition therapy (MNT) services that remain on the Medicare Telehealth Services List to continue to provide these services remotely as has ben done during the PHE except for:
o Outpatient hospitals no longer need to register patients’ homes as provider-based entities to allow hospitals to bill.
o Modifier -95 is required on claims from all providers, except for Critical Access Hospitals (CAHs) electing method II, as soon as participating hospitals can update their systems.
Place of Service (POS) codes have been clarified as well as the use of modifier -95:
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Use modifier -95 when the clinician is in the hospital and the patient is in the home, as well as for outpatient therapy services provided via telehealth by qualified PTs, OTs, or SLPs through December 31, 2024.
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Starting January 1, 2024 use POS codes as follows:
o POS 02- Telehealth to indicate the services billed were provided via telehealth when the originating site is other than the patient’s home.
o POS 10- Telehealth services when the patient is in their home.
Reach out to the trusted experts at The Rybar Group today for help with compliance and maximizing the use of telehealth services for your organization.