Coronavirus (Covid-19) Resources for Practices by Jordan Levin
As you know, the CDC and Health Departments have issued emergency alerts for the public, including guidance on preventative measure people can take to help avoid exposure. We have assembled some of the CDC resources for providers and patients which can be found by pressing one of these links. CDC Guidance on Covid-19 (English) (Spanish)
You should be sure to advise any patient who are worried about exposure of the following, patients with COVID-19 have experienced mild to severe respiratory illness. Symptoms can include fever, cough and shortness of breath. Symptoms may appear 2-14 days after exposure. Providers who have patients exhibiting these symptoms should be directed to CALL the office FIRST. They should be told to NOT come to the office, unless your office is prepared with proper infection control protocols in place (gloves, N-95 masks, regular cleaning of surfaces with antimicrobial alcohol and/or bleach based cleaners, patient distancing in the waiting areas, etc.). Offices are advised to give proper testing and treatment options via telemedicine visit and not risk exposing healthy patients to sick patients, or vice versa. Remember to ensure your staff if properly protected per OSHA, DOH, and CDC guidance.
Billing for telemedicine visits will be allowed by most governmental and commercial insurance companies, including Medicare and Medicaid. The CPT/HCPCS codes allowed by carriers do vary based on carrier. It is important to know most practices can bill normal E/M codes with either the POS code changed to 02 and/or the use of modifiers GT or 95. However prqc should be aware some carrier, including Medicare, will reduce payments by nearly 30% per their telemedicine rules. Recently, CMS has advised providers to instead submit claims with the 95 modifier and the POS code that matches where the payment would have normally been seen. Some carriers, such as Cigna, have advised providers to bill as if you were billing an office visit and for Coronavirus cases use the Z20.818 or Z20.828 as appropriate. Patient cost shares (i.e. deductible, copay, coinsurance) may still apply but carriers may cover them depending on the plan type. Visits not addressing Coronavirus will have regular cost share applied. Cigna rules may be found here.
CMS rules may be found here .
For billing and documentation purposes be sure to include in your notes how the service is rendered, telephone only, patient portal, or audio/video. Audio/Video is the most appropriate and best method for patient and provider and has the added benefit of paying the most. Google Due is HIPAA compliant and free, however, as long as a patient waives HIPAA you may use FaceTime or Skype to name a few. It is also important to note that the patient has requested, initiated, and consented to the telemedicine services.
Please check with your carriers for more specific details, or for clients please contact our office.
Remember, glove up, mask up, wash your hands with hot soapy water for at least 20 seconds, distance yourself from others by 6 feet, and be smart, this may last a while.
Be safe, and stay healthy.