The South Central Region Virtual Visit Billing Guides have been updated with the most recent payor changes. Below is this announcement's most recent updates, or click on any state to go directly to that state's guide.
Highlights:
Since the Federal Public Health Emergency (PHE), has not yet been renewed (currently set to end April 20th), several payors have not extended their telehealth policies beyond that. However, since the pandemic continues, the Federal PHE will almost certainly be renewed for another 90 days. We will closely monitor and post an update at the end of April. Due to the lack of a formal Federal PHE renewal, we saw limited changes in payor policies this month, with only a couple payors adding codes to their telehealth allowable list. However, Medicare was one payor that did add several allowable codes to their telehealth list, which will be very beneficial for facilities in increasing their telehealth utilization. A list of the 24 services Medicare added for the duration of the COVID-19 Federal PHE is provided below, ensure you review and incorporate into your telehealth program as applicable!
These guides were created to save you time and intended to provide overall information and education about virtual visits, however due to the volume of information in these guides, it can be difficult for healthcare providers to decipher the best workflow for their particular situation. We are finding in our work with organizations that there is no “one size fits all” solution. Each unique set-up and situation must be considered in formulating the best plan for your organization. If you would like some support in a plan, please reach out to us and we would be glad to discuss how we can help.
Below are more detailed key updates for regional and national payors since the guides were originally published.
Aetna
- Effective 4/1/21201, added 90849 to the list of two-way synchronous covered procedures with modifier GT or 95.
- Extended the cost share waiver for Medicare Advantage primary care telehealth visits for the duration of the Federal PHE.
Medicare
- Medicare updated their 2021 telehealth allowable code list adding 24 additional codes:
| Code | Short Descriptor |
| 92526 | Oral function therapy |
| 92550 | Tympanometry & reflex thresh |
| 92552 | Pure tone audiometry air |
| 92553 | Audiometry air & bone |
| 92555 | Speech threshold audiometry |
| 92556 | Speech audiometry complete |
| 92557 | Comprehensive hearing test |
| 92563 | Tone decay hearing test |
| 92565 | Stenger test pure tone |
| 92567 | Tympanometry |
| 92568 | Acoustic refl threshold tst |
| 92570 | Acoustic immitance testing |
| 92587 | Evoked auditory test limited |
| 92607 | Ex for speech device rx 1hr |
| 92608 | Ex for speech device rx addl |
| 92609 | Use of speech device service |
| 92610 | Evaluate swallowing function |
| 92625 | Tinnitus assessment |
| 92626 | Eval aud funcj 1st hour |
| 92627 | Eval aud funcj ea addl 15 |
| 96105 | Assessment of aphasia |
| 96125 | Cognitive test by hc pro |
| 97129 | Ther ivntj 1st 15 min |
| 97130 | Ther ivntj ea addl 15 min |
