Telemedicine Regulations

Facts Regarding Telehealth and Telemedicine Regulations as of 3/16/2020

 The Secretary of the Department of Health and Human Services (HHS) declared a Public Health Emergency due to COVID-19.

On Friday 3/13/3030 the World Health Organization declared COVID-19 a pandemic. There are currently 3,774 confirmed cases in the United States with over 69 deaths. 49 states have reported confirmed cases with Washington and New York, reporting 769 and 729 respectively. California reports 381 cases and Massachusetts, Colorado, Florida, Louisiana and Georgia all reporting more than one hundred confirmed cases.

To combat the spread of this virus, telehealth and telemedicine regulations have been relaxed. As of 3/16/2020 the following are the things you should know

  • The rural or HPSA restriction for telehealth has been suspended.
  • Telemedicine visits should be billed using 99307-99310 CPT codes with the Place of Service 02.
  • You can only bill the telehealth benefit once every 30 days.
  • These codes apply to any Medicare reimbursable visit not just for treatment of the coronavirus.
  • Medicare Advantage and Medicaid have enacted the same requirements. Check with you MAC or state for specifics
  • The communication modality MUST be HIPAA compliant and can be held through application technology on smartphones using 2-way audio and video capabilities between the provider and the patient/facility.
  • Telephony, store and forward or a one-way communication cannot be billed using these codes.
  • The facility, patient, family or caregiver must initiate the request.
  • The patient must be part of the video visit.
  • The patient must have a pre-existing relationship with the practitioner or a practitioner within the same TIN as demonstrated by having provided a reimburse claim to Medicare for a service or an item within the last 3 years from the date of the video visit.
  • All HIPAA regulations must be observed.

We will continue to send updates daily as the Coronavirus pandemic continues to evolve.

For further information contact us at 203-567-5260 or info@saisystems.com.