Advisory: PTs, Telehealth, and the CoronavirusSee the latest update from the Maryland Board
of Physical Therapy Examiners
April 24, 2020
Wondering whether you can provide PT services via telehealth during the COVID-19 outbreak? As the coronavirus continues to spread globally, members are asking about the possibility of reducing infection risk by conducting PT services through telehealth. There are important factors to consider, particularly related to telehealth services to Medicare and Medicaid beneficiaries. Read more
Ways to Advocate for Expansion of Telehealth Services
APTA Advisory: Pay Attention to Requirements When Billing Insurers for Services Delivered via Telehealth
This webinar from March 26th, is now available on demand. There is a post test for those seeking to access the course and receive CEUs.
Free for members and $25 for non. (Members must be signed in to the web site to get the course for free)
The course is approved for two (0.2) credit hours by the Maryland Board of Physical Therapy Examiners.
Telehealth, now more than ever, is an emerging treatment model that can be utilized for a variety of conditions. The benefits of providing telehealth services allows the therapist to meet the needs of increasing demands for patient-centered care with social distancing. This course will encourage therapists to expand their treatment protocols into the virtual world of medicine during these difficult times. Encouraging therapists to think outside the box and adapt their skill sets.
Challenges and Opportunities in Telehealth: A Q&A With the Experts
Step 1 is knowing what's allowed, and what isn't. Telehealth is in the news lately, as state and federal lawmakers debate the necessity and logistics of remote patient care and payment, including the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019. The bill, which APTA supports, would expand the use of telehealth services and ease restrictions on telehealth coverage under Medicare, as well as encourage the Center for Medicare and Medicaid Innovation to identify which services delivered via telehealth can result in cost-effective and positive patient outcomes. (Related Resource Did You Rapidly Adopt or Expand Telehealth for COVID-19? Here’s Our Post-Crisis Top 10 ‘To-Do’ List)
#PTTransforms Blog spoke to APTA members Sarah Gallagher, PT, DPT, and Alan Lee, PT, DPT, PhD, about the possibilities, challenges, and current use of telehealth across health care professions. Gallagher is the owner of South Valley Physical Therapy, a Colorado private practice specializing in neurologic and vestibular physical therapy that began providing telehealth services to solve an access to specialty care problem. Lee is the telehealth lead for the APTA Frontiers in Rehabilitation Science and Technology (FiRST) Council and vice president of the Technology in Physical Therapy Special Interest Group of HPA The Catalyst, APTA's section on health policy and administration. >> Read APTA's #PTTransforms BlogView the Full List
In addition, Maryland Medicaid does cover telehealth for PT, OT, and Speech. Email email@example.com for questions or requests for more information on the Medicaid Program.
CMS allows Private Practice and SNFs, Hospitals, HHAs, Rehab Agencies, Other Institutional Settings to bill for telehealth. Services that started as of March 1, 2020, and are provided for the duration of the public health emergency are eligible for new or established patients.
- PTAs working in private practices can furnish telehealth under Medicare Part B with services billed by the supervising PT,
- SNFs, Hospitals, HHAs, Rehab Agencies, Other Institutional Settings Can Bill Telehealth Outpatient Therapy Claims The clarification from CMS applies to settings that use institutional claims such as UB-04
- CPT codes eligible to be billed in the private practice setting: 97161- 97164, 97110, 97112, 97116, 97150, 97530, 97535, 97542, 97750, 97755, 97760, and 97761.
- Patients may be located in any geographic area (not just those designated as rural), and in any health care facility or in their home.
- Furnishing and Billing E-Visits: Addressing Your Questions
Third-party payment for telehealth depends on your contract with your payer.
During the national health emergency, APTA is maintaining a list of commercial payers that have made at least temporary policy revisions to cover telehealth services (.pdf) provided by PTs and PTAs. However, there is no list of third-party payers that pay for telehealth, so check with each payer. Also confirm with each payer whether the originating site can be a private home or office, if services must be real-time or can be asynchronous, and any other limitations to your use of telehealth. Review other considerations when billing for telehealth.
For billing, there are no "telehealth" CPT codes.
But before reporting CPT codes you traditionally use for clinical visits, check with your payer. Many of the physical medicine and rehab codes (97000 series) specify "direct 1-on-1 patient contact," which by strict definition would exclude telehealth unless you and your payer have agreed to include these services. A payer also may require an addendum attached to the bill that identifies the service as being provided via telehealth, along with an explanation of the charges, so be prepared to outline the reasoning for using telehealth.
You also should check with your payer about using place-of-service code "02" when billing for telehealth services to specify the entity where service(s) were rendered.
Regardless of the payer or policy, if you provide and bill for services using telehealth, make sure that you are practicing legally and ethically, and are adhering to state and federal practice guidelines and payer contract agreements.Coding and Billing Resources
- The Center for Connected Health Encounters offers "Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service (.pdf)," a 21-page document that outlines billing procedures.
- Telehealth Coverage Policies in the Time of COVID-19 to Date
- Maryland’s telehealth parity law requires telemedicine services to be reimbursed at the same rate as in-person medical services.
- Maryland Medicaid does cover telehealth. (Using modifier GT to bill - Place of Service: office)
Maryland Board of Physical Therapy Examiners Policy Position Statement on Telehealth.The Maryland Board of Physical Therapy Examiners permits the use of telehealth. Their 2019 position statement is to acknowledge the “intra-State” use of telehealth by Maryland licensees practicing physical therapy within the State of Maryland and to clarify that:
- Physical therapy practitioners must hold a valid Maryland license prior to providing physical therapy services via telehealth to clients physically located in Maryland; and,
- The practice of physical therapy, via telehealth or otherwise, in the State of Maryland must be in accordance with the Annotated Code of Maryland, Health Occupations Article, Title 10, and The Code of Maryland Regulations (COMAR), 10.38.01 – 10.38.11.
- PTAs and Telehealth: Supervising physical therapist" means a physical therapist who provides ongoing supervision to a physical therapist assistant regarding the care of a patient. Nothing prohibits supervision of/communication with the PTA being via telecommunication. Supervision of an aide CANNOT be remote. COMAR 10.38.01.01(B)(12) - Ongoing supervision" means that the physical therapist maintains continuing verbal and written contact with the physical therapist assistant to provide supervision and instruction adequate to ensure the safety and welfare of the patient.COMAR 10.38.03.01.B(21)