decisionhealth Newsletters, Part B News - 2020 Issue 4 (April)
Is it telehealth or something else? One question can clear things up during emergency
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Article Overview
This article helps billing and coding professionals understand how CMS guidance during the emergency affects remote patient encounters. It focuses on the broad categories of audio/visual telehealth, audio-only telephone services, online digital E/M services, and virtual check-ins, along with documentation and modifier-related considerations that support compliant reporting. The discussion is especially relevant to practices trying to determine which type of remote service was provided and how Medicare coverage applies.
Why This Topic Matters
Remote care guidance changed quickly during the emergency, creating confusion about which encounters qualify for telehealth versus other billable communication-based services. Clear classification affects billing accuracy, documentation, and Medicare reimbursement for physicians and non-physician practitioners.
Article Sections
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Question
Introduces the billing scenario and the confusion about whether different remote patient interactions should be treated as telehealth or another service type.
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Answer
Explains the general approach to distinguishing among remote encounter categories during the emergency and references Medicare and CPT guidance.
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Resources
Lists external Medicare and regulatory references related to telehealth coverage and emergency guidance.
What You Will Learn
- How to distinguish broad categories of remote patient encounters during the emergency
- What types of CMS and CPT guidance are relevant to telehealth, telephone, and online services
- Why documentation and communication method matter for remote service reporting
- When virtual check-ins may be considered in the context of remote care billing
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians
- Non-physician practitioners
- Practice managers
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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