Understand COVID-19 Situations and CMS Guideline on Remote patient care under Telehealth from the Physicians Office. Determine if All Revenue Codes and CPT/HCPCS, Modifiers Codes Are Up-to-Date, and Being Properly Reported. Be Prepared to Appreciate the Concept of Transparent Pricing and the Changes That Must Be Made By January 1, 2021.

Telemedicine services continue to grow both in volume and breadth of coverage. Much of the guidance for telemedicine or telehealth services comes from the Medicare program and changes occur almost every year. Making certain that all the rules and regulations in telemedicine services are faithfully followed can be challenging for Hospitals large and small. While the Medicare program has many rules and regulations in this area, private third-party payers tend to be more liberal in reimbursing for these types of services.

With the advent of the coronavirus COVID-19 pandemic, there is a new set of pressures on Telemedicine and telehealth. Proper coding and billing along with the appropriate provision of service must be understood and followed with due regard to both federal and state guidelines. Keeping up with these mandates is, at best, difficult. Also, the Medicare program must be kept separate from Medicare Advantage and private third-party payers relative to various directives. Overall there is a relaxation of the rules for telehealth provision and associated billing. Circumstances are very dynamic at this point with both federal (mainly Medicare) and state (mainly from the governors) mandates being issued. Some of these affect telehealth and will be covered comprehensibly.

The recently enacted 21st Century Cures Act direct CMS to expand telemedicine services. Remote robotic surgery is on the horizon. Medicare Advantage programs are being given more latitude in what they can include relative to telemedicine. Hospitals, clinics, and physicians must regularly update policies and procedures in this area to keep current as the technology continues to outstrip payment and compliance issues. The best expert on telehealth, Duane C. Abbey, CFP, comes to your classroom. Join this comprehensive 90 minutes of intermediate to the advanced level workshop on rapid changes in Telemedicine and its future including remote services.

Session Goals:-

• How is telemedicine supposed to work? Who is involved in telemedicine?
• What is the difference between telemedicine and telehealth? Why is it so confusing?
• Who is allowed to provide telemedicine services and any compliance issues?
• How are telemedicine services paid under the Medicare program?
• What do hospitals, CAHs, and clinics need to do in order to bill for telemedicine services?
• Is there anything special about RHCs (Rural Health Clinics)?
• How do private third-party payers view telemedicine and telehealth services?
• How will the 21st Century Cure Act impact telemedicine and telehealth?
• What will Medicare Advantage programs do with increasing latitude for the provision of telemedicine?

Session Agenda:-

• Telehealth Review and Overview
  • Telemedicine Services, and Telehealth Services
  • Physician coding for remote patient care services and teleconsultation billing guideline
  • Current Legislation – 21st Century Cures Act
  • Technologies - Interactive Communications, Electronic Monitoring, and Remote Robotic Services
• Clinical Issues for Telemedicine
  • Physicians Vs Non-Physician Practitioners Vs Consultation Services
  • What services can be provided? Who can provide services?
  • Where can services be provided?
  • New Place-Of-Service (POS) Code, Document needs under Covid-19 requirements
• Coding, Billing, and Reimbursement Issues
  • Understanding current CPT/HCPCS codes for telehealth patient care - Coding and Claims Filing Requirements
  • COVID-19 Rules for Emergency Billing under Telemedicine, and CMS Documentation Requirements
  • CMS New Waivers for Telehealth Visits during a pandemic - face to face Visit Codes, Video, Email.
  • Special Codes and Modifiers: Appropriate modifiers for coronavirus care through telehealth and their claims
  • Distant Site Consideration, Originating Site Considerations, and EXEMPTIONS
  • Medicare Payment Process and Rates
  • Special Considerations for CAHs and RHCs
• Compliance Issues for Telemedicine: Credentialing for Telemedicine Providers, Incident-To Services, Telepresenters
• Private Payer View of Telemedicine Services: More Liberal Usage Vs Cost Savings Perspective Vs Medicare Advantage Latitude
• Congressional Action Relative to Telehealth: 21st Century Cures Act – Section, and Proposed CONNECT ActSession Objectives
  • To understand the general concept of telemedicine and how it works during the Coronavirus COVID-19 crisis.
  • To appreciate the underlying technology and advancements that allows telemedicine services to work.
  • To understand the changes over the past few weeks by CMS and all levels used in telemedicine.
  • To review the current Medicare rules and regulations surrounding telemedicine services.
  • To understand special requirements for physicians and practitioners.
  • To appreciate how to code, bill, and the reimbursement process for telemedicine services under the Medicare program.
  • To appreciate clinical and billing privileges surrounding telemedicine.
  • To review changes in credentialing for physicians providing telehealth services.
  • To review changes in coverage and types of services that can be provided through telemedicine.
  • To assess unusual requirements for different providers relative to telemedicine services.
  • To discuss how private third-party payers view telemedicine.
  • To review the new latitude that Medicare Advantage programs have in the telemedicine area.
  • To review the 21st Century Cures Act relative to telemedicine.
  • To assess future technological changes for telemedicine particularly with Medicare.

Who will Benefit?

• Coders, Billers, Auditors, Office Managers
• Hospital/CAH Case Management and Utilization Review Personnel
• Hospital/CAH Coding Personnel
• Billing and Claims Transaction Personnel
• Outpatient Service Area Personnel, Nursing Staff
• Chargemaster Coordinators, Financial Analysts
• Compliance Personnel
• Physicians, Non-Physician Practitioners, and Other Interested Personnel