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:
The 2023 Medicare Physician final rule brought new allowable Medicare telehealth services, but also confirmed the future termination of multiple waivers currently in place for the federal public health emergency (PHE). The Consolidated Appropriations Act, signed into law earlier this year, extended certain telehealth flexibilities for Medicare patients for 151 days after the official end of the PHE. CMS confirmed that on day 152, the waivers listed below would be terminated. One of the most significant waivers is the termination of the originating site waiver, which will require Medicare patients to once again to visit a qualified originating site (not patient’s home) to receive telehealth services unless it is for tele-mental health. CMS did add several new services to the allowable telehealth list, including 5 new permanent telehealth codes for prolonged E/M services and chronic pain management and 54 codes to the category 3 telehealth list that be available for use through the end of 2023. The COVID-19 Public Health Emergency is set to expire January 11th, 2023, however it is expected to be renewed for another 90-day period, as DHHS has stated that they will provide a 60-day notice before termination. Due to the probable extension, commercial payors continue to allow their COVID flexibilities. However, most payors have reverted to permanent policies with only a few expectations for the COVID PHE. Below are the detailed highlights:
BCBS of MS
- Added store and forward information
Mississippi Medicaid
- Added documentation information
UHC
- Add interprofessional code information
- Updated eligible telehealth code list
UHC Community Plan of Tennessee
- Added additional services considered for telehealth reimbursement
- Updated UHC telehealth allowable code list
Medicare
- The below waivers will expire on day 152 post PHE:
- Originating site restriction waiver
- Expanded list of allowable telehealth practitioners
- Audio only telehealth services
- However, audio only mental telehealth services will still be allowed on a permanent basis if certain criteria are met
- In person requirement for mental health services via telehealth
- Extension of FQHC/RHC to serve as originating site
- Updated allowable modifiers and POS for during PHE and post PHE
