Code Encounters

Per CMS: they have “established an internal process to evaluate and streamline regulations with a goal to reduce unnecessary burden, to increase efficiencies, and to improve the beneficiary experience. In carrying out this internal process CMS is moving the needle and removing regulatory obstacles that get in the way of providers spending time with patients.”

OIG announced that they reviewed 100 telehealth claims performed in 2014 and 2015. Of the claims they found that 31 did not meet telehealth requirements.

President Trump signed and issued an Executive Order on Improving Rural and Telehealth Access that would expand the telehealth benefits permanently. Physician Fee Schedule Proposed Rule would make some telehealth and workforce flexibilities that were provided since the COVID-19 Public Health Emergency. It also focusing on improving access and convenience of care for Medicare beneficiaries, particularly those living in rural areas. One area the order also addresses is a multi- year effort to reduce clinician burden under Patients over Paperwork Initiative.

Telehealth flexibilities and waivers have been expanded - Here's what you need to know.

Today, the US Department of Health and Human Services (HHS) through the HRSA (Health Resources and Services Administration) has provided $225 million to Rural Health Clinics (RHC) for COVID-19 testing.

It has been a confusing and chaotic time for healthcare providers.  On 5/1 CMS again made changes to their directives for telehealth.  Among providers affected by these changes are RHC providers, professional services and providers who have been using telephone only codes and outpatient hospital based clinics.  They have also clarified the use of Modifier CS.  CMS stated they now realize a large population of Medicare beneficiaries do not have access to asynchronous communication (real time audio/video) and to assist beneficiaries and providers there are now additional codes that allow telephone only interaction.