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January 25, 2018


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Medical Coding News Archives

Status of Telehealth Services in Proposed Rule

 
August 16, 2011:

Karen H. Kachur, RN, CPC

In the proposed Medicare physician fee schedule rule released in the Federal Register on July 19, 2011, several additional services were recommended for inclusion as covered telehealth services for 2012, including:
  • Smoking cessation services
  • Critical care services
  • Domiciliary or rest home evaluation and management services
  • Genetic counseling
  • Online evaluation and management services
  • Data collection services
  • Audiology services

After consideration, CMS concluded that smoking cessation services are similar to other currently covered telehealth services (e.g., educational services related to the care of chronic kidney disease and medical nutrition therapy) and benefits should be provided. The agency has proposed adding the following applicable codes to the list of covered telehealth services for CY 2012:

99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes and up to 10 minutes

99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes

G0436 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes

G0437 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes

Requests were also submitted to the agency advocating the inclusion of critical care codes 99291 and 99292 to the list of covered telehealth services. However, CMS failed to find evidence that supported the use of a telecommunications system to deliver these services, and proposed to deny the inclusion of these codes as approved telehealth services.

A request was also made to include the codes for domiciliary or rest home evaluation and management services (codes 99334–99337) as covered telehealth services. However, this request was denied as current law does not allow these places of service to serve as an originating site for telehealth services.

A request to add genetic counseling services (CPT code 96040) to the list of covered telehealth services was also denied. Because this code would only be reported by genetic counselors and these practitioners cannot bill Medicare directly for their services and are also not on the list of practitioners who can provide telehealth services, CMS felt it inappropriate to add this service to the list of covered Medicare telehealth services.

The inclusion of online evaluation and management services, reported with CPT code 99444, on the list of covered telehealth services was also denied. This code is currently noncovered under Medicare, and for that reason, cannot be included as a covered telehealth service.

A request to add codes 99090 and 99091 for data collection services as covered telehealth services was also denied, as payment for these services is always bundled into payment for another service.

A request from the American Academy of Audiology asked that CMS add services provided by audiologists for balance disorders and hearing loss to the list of Medicare telehealth services. However, as audiologists are not included as covered providers for telehealth services, this request was denied.

 

 
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