The American Medical Association recently released a coding guide to help providers process payments for telehealth services during the coronavirus pandemic.
The document outlines 11 different scenarios for treating patients through telehealth as well as the necessary codes for qualifying for Medicare reimbursement.
Earlier this month, the Trump administration expanded Medicare telehealth coverage for beneficiaries. Beginning March 6, CMS is paying physicians for telehealth at the same rate as in-person visits for all diagnoses, not just services related to COVID-19.
The first two scenarios described by the AMA provide guidance for when a patient comes to into the office and is tested for COVID-19 as well as when a patient comes into the office and is redirected to a testing site for COVID-19.
Here are nine telehealth scenarios related to COVID-19 that the AMA provides coding guidance and resources for:
1. A patient participates in a telehealth visit and is directed to go to a physician office or physician's group practice site for testing.
2. A patient participates in a telehealth visit and is directed to an unaffiliated testing site.
3. A patient receives a virtual check-in or online visit and is directed to go to a physician office for testing.
4. A patient receives a virtual check-in or online visit and is directed to an unaffiliated testing site.
5. A COVID-19 diagnosed patient participates in a telehealth visit.
6. A COVID-19 patient participates in a virtual check-in or online visit via the patient portal, email or telephone call from a qualified nonphysician.
7. A physician orders remote physiologic monitoring following a patient being quarantined at home after being diagnosed with COVID-19.
8. A non-COVID-19 patient participates in a telehealth visit.
9. A non-COVID-19 patient participates in a virtual check-in or online visit via the patient portal, email or telephone call from a qualified nonphysician.