Telehealth Coding Set

Physicians can now offer more services via telehealth and get paid.

The Centers for Medicare & Medicaid Services (CMS) is adding 11 codes to the list of telehealth services payable under the Medicare Physician Fee Schedule (MPFS). Coverage is retroactive to March 1, 2020, and is effective for the duration of the public health emergency (PHE) for COVID-19.

Health and Human Services Secretary Alex Azar recently extended the PHE another 90 days, to expire Jan. 21, 2021.

Take Note of These Codes

The 11 CPT® and HCPCS Level II codes added on Oct. 14 are:

93797 Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session)
93798 with continuous ECG monitoring (per session)
93750 Interrogation of ventricular assist device (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performed, and report
95970 Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain, cranial nerve, spinal cord, peripheral nerve, or sacral nerve, neurostimulator pulse generator/transmitter, without programming
95971 with simple spinal cord or peripheral nerve (eg, sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional
95972 with complex spinal cord or peripheral nerve (eg, sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional
95983 with brain neurostimulator pulse generator/transmitter programming, first 15 minutes face-to-face time with physician or other qualified health care professional
+95984 with brain neurostimulator pulse generator/transmitter programming, each additional 15 minutes face-to-face time with physician or other qualified health care professional (List separately in addition to code for primary procedure)
G0422 Intensive cardiac rehabilitation; with or without continuous ECG monitoring with exercise, per session
G0423 with or without continuous ECG monitoring; without exercise, per session
G0424 Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day

Download the covered telehealth services list to see all the codes payable under the MPFS. Remember to note in the list which services are payable only when furnished via telehealth during the PHE for COVID-19 (dates of service on or after March 1, 2020, until the PHE expires). Also note which services may be furnished using audio-only communications technology and any limitations to Medicare payment.

It All Adds Up

Since the beginning of the PHE, CMS has added over 135 codes to the Medicare telehealth services list for emergency department visits, initial inpatient and nursing facility visits, discharge day management services, and more.

According to CMS, “Between mid-March and mid-August 2020, over 12.1 million Medicare beneficiaries – over 36 percent – of people with Medicare Fee-For-Service have received a telemedicine service.”

For More Information: https://www.aapc.com/blog/52048-cms-adds-11-codes-to-telehealth-list/

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