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New Guidance on Coding During COVID-19



Source: American Medical Association


The American Medical Association (AMA) has worked to ensure that all payors are applying the greatest flexibility to our physicians in providing care to their patients during this public health crisis.


The Centers for Medicare & Medicaid Services (CMS) lifted Medicare restrictions on the use of telehealth services during the COVID-19 emergency. Key changes effective March 1, and lasting throughout the national public health emergency include:

  • Medicare will pay physicians for telehealth services at the same rate as in-person visits for all diagnoses, not just services related to COVID-19.

  • Patients can receive telehealth services in all areas of the country and in all settings, including at their home.

  • CMS expanded the list of services eligible to be reported via telehealth (link here) • CMS will permit reporting of telehealth E/M office or other outpatient visits based on time or Medical Decision Making (MDM).

  • The Qualified Healthcare Professionals that are eligible for telehealth has been expanded. Additional codes for these services were also added to the CMS telehealth list.

  • CMS has clarified that telehealth services are permitted with both new and established patients.

  • Physicians can reduce or waive cost-sharing for telehealth visits. In addition, all cost-sharing for Medicare beneficiaries is waived for COVID19 testing and visits related to the testing. Modifier CS – Cost sharing must be appended to these claims to ensure cost-sharing.

  • Physicians licensed in one state can provide services to Medicare beneficiaries in another state. State licensure laws still apply.


More here.

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